Dr John Kazianis on What We Have Learned, and Can Continue to Learn, From Tele-ICUs

Tele–intensive care units (ICUs) help to address coverage gaps and improve both compliance with best practices and quality outcomes, but because they consume a lot of resources, it’s important to figure out how to implement them to improve outcomes across the board, noted John Kazianis, MD, clinical associate professor, Yale School of Medicine, and intensivist and medical director, InSight Tele-ICU, Yale New Haven Hospital, when discussing his presentation from day 1 of this year’s CHEST Annual Meeting.

Transcript

In your presentation yesterday, “Tele-ICU After 20 Years: Benefits, Downsides, and What the Future Holds,” what did you discuss?

I was asked to speak about the benefits and downsides and the potential future of tele-ICUs. And in terms of the benefits, I think we know for sure that tele-ICUs have the capability of improving outcomes for patients that are admitted to ICUs. We know that tele-ICU can help address gaps in clinical coverage, either at night or in geographic areas in this country where there aren’t enough intensivists to cover. We also know that tele-ICUs can improve compliance with best practices and improve quality outcomes, so we know that they can be beneficial.

The downside to tele-ICUs is that they consume a lot of resources. And the data have shown that while they have increased in their implementation around the country, they don’t always work. And so the key to, and one of the things that I am interested in figuring out, is what are the aspects of tele-ICUs that really make them beneficial and how do we implement them in a way that improves outcomes across the board.

What have we learned about telehealth benefits and downsides after 2 decades of this practice?

You know, I would say that one of the things that we’ve learned is that the traditional thinking that tele-ICUs are meant for rural areas only, places where they don’t have access to pulmonologists or intensivists, that that thinking is only partly true and that there’s probably a niche for ICU telehealth in a variety of bedside staffing models. And we just need to figure out what the best way to implement it is. I think that we’re going to be seeing tele-ICUs increase in their utilization, certainly after the pandemic, but the key to making them work will be figuring out how to implement them and what types of projects they should be responsible for, in order to improve patient outcomes.