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Evidence Check - Clinical models of care

Triage, virtual care, temporary hospitals, ethics.

Telemedicine in intensive care units evidence check

Added: 20 Mar 2020

What telemedicine models or interventions are associated with improved outcomes for people in the intensive care unit?
  • In the setting of intensive care units (ICU), telemedicine generally uses audio visual technologies to assist in patient care by connecting an intensive care specialist who is not on site
  • There are two models of telemedicine in ICUs that are most commonly described. hub-and-spoke model and virtual consultations.
  • Hub-and-spoke models describe a model which uses a single remote centre (hub) in a fixed location to provide tele-critical care services to multiple local locations (spokes) simultaneously. Differences in definitions of the model make it challenging to draw conclusions on outcomes, but some studies show a reduction in hospital mortality
  • Virtual consultations involves a remote intensivist virtually reviewing one patient at a time using audio-video connectivity. It has shown some improvement in reducing ICU and total hospital mortality, but no significant difference in length of stay in pre/post studies

Daily Evidence Digest

Rapid evidence checks are based on a simplified review method and may not be entirely exhaustive, but aim to provide a balanced assessment of what is already known about a specific problem or issue. This brief has not been peer-reviewed and should not be a substitute for individual clinical judgement, nor is it an endorsed position of NSW Health.

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