Tele-Critical Care at 25 Years Old

How tele-critical care has evolved and changed

“It is not the strongest of the species that survives, nor the most intel-ligent, but the one most responsive to change.”- Charles Darwin

The tele-ICU concept, recently renamed Tele-Critical Care (Tele-CC), is approximately a quarter century old. We should take this time to review and reflect on how the approach to Tele-CC has changed and how its character-istics have evolved.In the late 1990s/early 2000s, organizations such as the National Quality Forum, The Leapfrog Institute, and the Agency for Healthcare Research and Quality were calling for full-time onsite intensivist care 24 h a day, 7 days a week at the 7,500 ICUs across the United States.

However, in the year 2000, the intensivist shortage was estimated to be approximately 23,000–24,000 to meet these around-the-clock bedside needs. The shortage was expected to worsen by the year 2020 due to the aging of the U.S. population. Several factors have poten-tially attenuated the predicted intensivist shortage. These include a slow but progressive expansion of Tele-CC pro-grams (less than 8% of U.S. ICU beds in 2010 to 25% by 2018), a steady increase in the number of accredited critical care training programs (369 in 2008 to 462 in 2018),5an increased number of critical care fellowship positions (2,003 in 2008 to 3,074 in 2018), and estimated increases in critical care physician assistants and advanced practice nurses by 54% and 119%, respectively, by 2025.

Want to read more? Head here: https://doi.org/10.30953/thmt.v9.490

• Erkan Hassan, PharmD, FCCM | Transformational Views Consulting, Group, Inc., Clarksville, Maryland, USA