ATA's tele-ICU guidelines aim to ensure patient safety

Draft guidance published by the American Telemedicine Association this week focuses on the use of telecommunications technologies in intensive care settings.

The stated aim of the guidance, for which ATA is accepting comments through April 26, is to "assist practitioners in pursuing a sound course of action to provide effective and safe medical care that is founded on current information, available resources and patient needs," according to its authors. What's more, the authors said, the guidelines are meant for tele-ICU services only, and should not be applied to overall ICU care.

"Approximately 13 percent of the nation's adult ICU beds have tele-ICU coverage with a majority of coverage in academic and private hospitals," the authors said, citing a 2013 statistic from the New England Healthcare Institute. "This patient population has the highest cost impact in any organization. The patients are critically ill with many concurrent and emergent needs that occur throughout their ICU stay… By using advanced communication technologies, [tele-ICU] teams are able to leverage clinical expertise across a spectrum of patients in a variety of clinical settings."

The guidelines are divided into three sections:

  • Administrative guidelines
  • Clinical application guidelines
  • Technical guidelines

Among the administrative guidelines shared, the authors said that executive leadership must ensure that tele-ICU clinical leaders are in a position to make necessary decisions. Escalation processes, they added, must be developed to focus on patient safety and that "allow healthcare professionals advocacy on behalf of patients and their families."

The administrative guidelines also call on all tele-ICU professionals to be fully licensed, registered and credentialed, and require patient privacy to be a priority.

With regard to clinical application guidelines, the authors provide recommendations for operational hours, the types of patients to be served, staffing models, workflow and integration strategies, as well as training and quality performance.

The guidelines call on organizations using tele-ICUs to ensure that technology used "optimizes audio and visual clarity for enhancements of clinical assessment." They also provide recommendations for bandwidth used to connect disparate equipment , as well as infection control efforts.

A recent review of research on tele-ICU published in Telemedicine and e-Health determined that despite the cost of implementation, hospitals could benefit more from the use of tele-ICU tools both financially and in terms of the quality of care delivered to patients.

More specifically, research published in December in the CHEST Journal determined that use tele-ICU technology improved ICU survival and discharge rates. For that study, Craig Lilly, Director of the eICU Program at Worcester, Mass.-based UMass Memorial Medical Center, and a team of researchers examined the impact of tele-ICU technology across 56 intensive care units, 32 hospitals and 19 health systems over a five-year period.

To learn more:
- here's the ATA guidance (.pdf)