Abstract

Background: Telemedicine ICU (Tele-ICU) programs are command centers staffed with intensivists and critical care nurses who electronically aid and deliver real-time information to frontline clinicians. The benefits of Tele-ICU are numerous, but the few existing barriers often prove insurmountable, accounting for slow adoption in rural and underserved areas where it is needed most. Remote monitoring quickly detects patient deterioration, while consultation provided by remote intensivists expands the capabilities of smaller facilities. The arrival of COVID-19 has brought with it urgency, paving the pathway for successful adaptation of tele-intensive care concepts.  

Objective: The goal of this scoping review is to map out the available published data regarding healthcare professionals’ experiences with implementing Tele-ICU modalities during the pandemic.   

Methods: We conducted a scoping review of various ICU modalities employed during the COVID pandemic to date. Following PRISMA guidelines, we searched peer-reviewed literature in the English language published from October 2020 through October 2021 (during the COVID-19 pandemic). Using the databases PubMed/MEDLINE and CINAHL, we utilized a Boolean search strategy, combining the following search terms:  "Telemedicine” or “Virtual” or “Tele-ICU” or “digital health” or “Tele-intensive care” and “ICU” or “intensive care” and “COVID-19” or “pandemic.”   

Results: Our search yielded 1067 records in PubMed and 16 results in CINAHL. We excluded all works that fell outside the pandemic timeline. After dropping duplicates and evaluating the articles for relevance criteria, 19 articles were selected for this review. Studies included came from various countries, including the United States, Israel, the United Kingdom, Egypt, India, China, Brazil, Mexico, and Malaysia. We identified five major areas of Tele-ICU used: teleconsultation, tele-rounding, telemonitoring, video conferencing and infrastructure changes.  

Conclusion: The findings of this scoping review show a wide variety of improvised platforms with a common theme of interdisciplinary and family collaboration in the care of critical patients. Existing Tele-ICU systems have been expanded and novel programs launched. A groundbreaking national network in the U.S. (NETCCN) will standardize deployment of Tele-ICU for the critically ill. Future research should focus on determining the most reliable forms of remote communication, practical composition of Tele-ICU teams, and standardized access to the electronic health record.