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. 2024 May 13;6(5):e1091.
doi: 10.1097/CCE.0000000000001091. eCollection 2024 May.

National Emergency Tele-Critical Care in a Pandemic: Barriers and Solutions

Jeremy C Pamplin  1   2 , Brooke Gray  2   3 , Matthew T Quinn  2 , Jeanette R Little  2 , Christopher J Colombo  2   4 , Sanjay Subramanian  5   6 , Joseph C Farmer  7   8 , Michael Ries  9 , Benjamin Scott  10 ; Governance Stakeholder Working Group and National Emergency Tele-Critical Care Network Team Participants
Collaborators, Affiliations

National Emergency Tele-Critical Care in a Pandemic: Barriers and Solutions

Jeremy C Pamplin et al. Crit Care Explor. .

Abstract

The COVID-19 pandemic caused tremendous disruption to the U.S. healthcare system and nearly crippled some hospitals during large patient surges. Limited ICU beds across the country further exacerbated these challenges. Telemedicine, specifically tele-critical care (TCC), can expand a hospital's clinical capabilities through remote expertise and increase capacity by offloading some monitoring to remote teams. Unfortunately, the rapid deployment of telemedicine, especially TCC, is constrained by multiple barriers. In the summer of 2020, to support the National Emergency Tele-Critical Care Network (NETCCN) deployment, more than 50 national leaders in applying telemedicine technologies to critical care assembled to provide their opinions about barriers to NETCCN implementation and strategies to overcome them. Through consensus, these experts developed white papers that formed the basis of this article. Herein, the authors share their experience and propose multiple solutions to barriers presented by laws, local policies and cultures, and individual perspectives according to a minimum, better, best paradigm for TCC delivery in the setting of a national disaster. Cross-state licensure and local privileging of virtual experts were identified as the most significant barriers to rapid deployment of services, whereas refining the model of TCC to achieve the best outcomes and defining the best financial model is the most significant for long-term success. Ultimately, we conclude that a rapidly deployable national telemedicine response system is achievable.

Keywords: critical care; delivery of healthcare; health resources; pandemic; rural health; telemedicine.

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Conflict of interest statement

Dr. Subramanian declares that he is the Chief Executive Officer (CEO) of Omnicure, which provided one of the software platforms used in the National Emergency Tele-Critical Care Network (NETCCN) project. Dr. Farmer declares that he is the CEO of a consulting firm called Trajectory Group, LLC; he consulted for the Avel eCare, one of the software platforms used in the NETCCN project. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

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