Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Intelligence and Informatics in Medicine, Medical Center rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
J Med Internet Res. 2021 Nov 3;23(11):e32264. doi: 10.2196/32264.
The role of telemedicine in intensive care has been increasing steadily. Tele-intensive care unit (ICU) interventions are varied and can be used in different levels of treatment, often with direct implications for the intensive care processes. Although a substantial body of primary and secondary literature has been published on the topic, there is a need for broadening the understanding of the organizational factors influencing the effectiveness of telemedical interventions in the ICU.
This scoping review aims to provide a map of existing evidence on tele-ICU interventions, focusing on the analysis of the implementation context and identifying areas for further technological research.
A research protocol outlining the method has been published in JMIR Research Protocols. This review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A core research team was assembled to provide feedback and discuss findings.
A total of 3019 results were retrieved. After screening, 25 studies were included in the final analysis. We were able to characterize the context of tele-ICU studies and identify three use cases for tele-ICU interventions. The first use case is extending coverage, which describes interventions aimed at extending the availability of intensive care capabilities. The second use case is improving compliance, which includes interventions targeted at improving patient safety, intensive care best practices, and quality of care. The third use case, facilitating transfer, describes telemedicine interventions targeted toward the management of patient transfers to or from the ICU.
The benefits of tele-ICU interventions have been well documented for centralized systems aimed at extending critical care capabilities in a community setting and improving care compliance in tertiary hospitals. No strong evidence has been found on the reduction of patient transfers following tele-ICU intervention.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/19695.
远程医疗在重症监护中的作用稳步增加。远程重症监护单元 (ICU) 的干预措施多种多样，可以在不同的治疗水平上使用，通常对重症监护过程有直接影响。尽管已经发表了大量关于该主题的原始和二次文献，但需要扩大对影响远程医疗干预在 ICU 中有效性的组织因素的理解。
本范围综述旨在提供远程 ICU 干预措施现有证据的图谱，重点分析实施背景，并确定进一步技术研究的领域。
已在 JMIR 研究方案中发布了概述方法的研究方案。本综述遵循 PRISMA-ScR（系统评价和荟萃分析扩展的首选报告项目用于范围综述）。一个核心研究团队被组建来提供反馈并讨论研究结果。
共检索到 3019 项结果。经过筛选，最终有 25 项研究纳入了最终分析。我们能够描述远程 ICU 研究的背景，并确定远程 ICU 干预的三种用例。第一种用例是扩展覆盖范围，描述了旨在扩展重症监护能力可用性的干预措施。第二种用例是提高合规性，包括旨在提高患者安全性、重症监护最佳实践和护理质量的干预措施。第三种用例是促进转移，描述了针对 ICU 内或从 ICU 转移患者管理的远程医疗干预措施。
远程 ICU 干预措施的益处已在集中式系统中得到充分证明，这些系统旨在扩展社区环境中的重症监护能力，并提高三级医院的护理合规性。没有发现远程 ICU 干预后减少患者转移的有力证据。
国际注册报告标识符 (IRRID)：RR2-10.2196/19695。
