This text provides a concise, yet comprehensive overview of telemedicine in the ICU. The first part of the book reviews common issues faced by practitioners and hospital administrators in implementing and managing tele-ICU programs, including the merits of different staffing models, the challenges of building homegrown programs versus contracting for services, and the impact of state laws and payer policies on reimbursement for tele-ICU services. The second part of the book presents the current state of evidence for and against ICU telemedicine, based on clinical trials, before-and-after implementation studies, and observational data. The third part dives deeper into specific use cases for telemedicine in the ICU, including telestroke, pediatric and cardiac intensive care, and early treatment of declining patients with sepsis. Written by experts in the field, Telemedicine in the ICU is a practical guide for intensive care physicians and hospital administrators that provides all the information necessary in building and maintaining a successful tele-ICU program.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
This book provides an overview of key issues with regards to implementing telemedicine services as well as an in depth overview of telemedicine in pulmonary, critical care, and sleep medicine. Topics range from specific practices to program development. Telemedicine has experienced explosive growth in recent years and yet, implementing telemedicine solutions is complex with substantial regulatory, legal, financial, logistical, and intra-organization/intra-personal barriers that must be overcome. This book provides the necessary information and guidance to address those complex issues. This book is broadly divided into two parts 1) a primer on requisite steps before embarking on telemedicine service development and 2) specific applications and examples where telemedicine is successfully utilized to improve quality of care in pulmonary, critical care, and sleep medicine. The first part includes coverage of telemedicine and finance, regulatory and legal issues, and program development. The second part delves into specifics with information on ambulatory telemedicine programs, inpatient consultations, and tele-ICU programs. All chapters are written by interprofessional authors that are leaders in the field of telemedicine with extensive knowledge of diverse telemedicine programs and robust real-world experience on the topic. This is an ideal guide for telehealth program managers, and pulmonary, critical care, and sleep medicine professionals interested in improving their telehealth practice.
This book identifies the key scientific articles in the field of Intensive Care and explains why these papers are important in contemporary clinical management. Identifying those influential contributors who have shaped the practice of modern Intensive care practice, the book includes commentaries on 50 seminal papers in a wide range of areas. enal This an invaluable reference for trainees, fellows, and surgeons studying for exams, as well as for seasoned surgeons and physicians who want to stay current in their field.
Now in paperback, the second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely this text takes a problem-orientated approach providing a key resource for daily clinical issues in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Careprovides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients.
Evidence-Based Practice of Critical Care, edited by Drs. Clifford S. Deutschman and Patrick J. Neligan, provides objective data and expert guidance to help answer the most important questions challenging ICU physicians today. It discusses the clinical options, examines the relevant research, and presents expert recommendations on everything from acute organ failure to prevention issues. An outstanding source for "best practices" in critical care medicine, this book is a valuable framework for translating evidence into practice. Gain valuable evidence-based recommendations on key topics such as acute organ failure, infection, sepsis and inflammation, and prevention issues pointing the way to the most effective approaches. Get an overview of each question, an outline of management options, a review of the relevant evidence, areas of uncertainty, existing management guidelines, and authors’ recommendations. Navigate a full range of challenges from routine care to complicated and special situations. Find the information you need quickly with tables that summarize the available literature and recommended clinical approaches.
For many years, intensive care has focused on avoiding immediate death from acute, life-threatening conditions. However, there are increasing reports of a number of lingering consequences for those who do indeed survive intensive care. Examples include on-going high risk of death, neurocognitive defects, significant caregiver burden, and continued high healthcare costs. Surviving Intensive Care, written by the world's experts in this area, is dedicated to better understanding the consequences of surviving intensive care and is intended to provide a synopsis of the current knowledge and a stimulus for future research and improved care of the critically ill.
This book is one of the first to comprehensively summarise the latest thinking and research in the rapidly evolving field of quality management in intensive care. Quality indicators and outcome measures are discussed with a practical focus on patient-centred, evidence-based implementation for safer and more effective clinical practice. Chapters on topics such as teambuilding, patient satisfaction, mortality and morbidity, and electronic management systems are organised into three sections, covering quality management at the scale of the individual patient, the intensive care unit, and the national and international level. Written by a team of over forty international experts in the specialty, with editors who have been heavily involved for many years with the European Society of Intensive Care Medicine, the book reflects commonly accepted goals and guidelines for best practice, and will be valuable for practitioners worldwide. The ideal one-stop resource for intensive care physicians as well as ICU and hospital managers.
The first complete guide to the rapidly expanding field of telehealth From email to videoconferencing, telehealth puts real-time healthcare solutions at patients’ and clinicians’ fingertips. Every year, the field continues to evolve, enhancing access to healthcare, supporting clinicians, and improving the patient experience. However, since telehealth is in its infancy, no text has offered a comprehensive, definitive survey of this up-and-coming field—until now. Written by past presidents of the American Telemedicine Association, Understanding Telehealth explains how clinical applications leveraging telehealth technology are optimizing healthcare delivery. In addition, this timely resource examines the bedrock principles of telehealth and highlights the safety standards involved in the diagnosis and treatment of patients through digital communications. Logically organized and supported by high-yield clinical vignettes, the book begins with essential background information, including a look at telehealth history, definitions and roles, and rural health. It then provides an overview of clinical services for adults, from telestroke to telepsychiatry. The third section addresses pediatric clinical services, encompassing pediatric emergency and critical care, telecardiology, and more. A groundbreaking resource: •Chapters cover a broad spectrum of technologies, evidence-based guidelines, and application of telehealth across the healthcare continuum •Ideal for medical staff, public healthcare executives, hospitals, clinics, payors, healthcare advocates, and researchers alike •Incisive coverage of the legal and regulatory environment underpinning telehealth practice
The authors of this book set out a system of safety strategies and interventions for managing patient safety on a day-to-day basis and improving safety over the long term. These strategies are applicable at all levels of the healthcare system from the frontline to the regulation and governance of the system. There have been many advances in patient safety, but we now need a new and broader vision that encompasses care throughout the patient’s journey. The authors argue that we need to see safety through the patient’s eyes, to consider how safety is managed in different contexts and to develop a wider strategic and practical vision in which patient safety is recast as the management of risk over time. Most safety improvement strategies aim to improve reliability and move closer toward optimal care. However, healthcare will always be under pressure and we also require ways of managing safety when conditions are difficult. We need to make more use of strategies concerned with detecting, controlling, managing and responding to risk. Strategies for managing safety in highly standardised and controlled environments are necessarily different from those in which clinicians constantly have to adapt and respond to changing circumstances. This work is supported by the Health Foundation. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. The charity’s aim is a healthier population in the UK, supported by high quality health care that can be equitably accessed. The Foundation carries out policy analysis and makes grants to front-line teams to try ideas in practice and supports research into what works to make people’s lives healthier and improve the health care system, with a particular emphasis on how to make successful change happen. A key part of the work is to make links between the knowledge of those working to deliver health and health care with research evidence and analysis. The aspiration is to create a virtuous circle, using what works on the ground to inform effective policymaking and vice versa. Good health and health care are vital for a flourishing society. Through sharing what is known, collaboration and building people’s skills and knowledge, the Foundation aims to make a difference and contribute to a healthier population.
