Deciphering factors that influence the value of tele-ICU programs
The underlying drivers for ICU telemedicine solutions have primarily been the critical care resource supply/demand mismatch: an aging population with increased ICU utilization and geographic concentration of intensivists in large urban areas, creating access issues elsewhere. A recent systematic review and meta-analysis described significant positive effects of tele-ICU implementation on ICU mortality and length of stay (LOS), which less consistently also translate into reductions of hospital mortality and LOS, as a variety of non-ICU-driven factors influence those metrics (see Table) . Our own recent meta-analysis adds that, while overall ICU mortality reductions can be expected through tele-ICU implementation, the largest ICU mortality improvements can be expected in ICUs with high pre-implementation standardized ICU mortality ratios (observed over expected by risk prediction) .
We have also learned that how tele-ICU implementations are planned and executed...
Compliance with ethical standards
Conflicts of interest
CB., M.F. and C.S. have no conflicts of interest.
An approval by an ethics committee was not applicable.