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Using electronic medical record notes to measure ICU telemedicine utilization
Amy M J O'Shea1,2, Mary Vaughan Sarrazin1,2, Boulos Nassar3,4
1Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, USA.
Summary
A standardized clinical note template helps document telemedicine use in intensive care units (ICUs). Bedside staff, especially nurses, frequently initiated these interactions, influencing patient care changes.
Area of Science:
- Health Services Research
- Medical Informatics
- Critical Care Medicine
Background:
- High-acuity healthcare complexity necessitates clear documentation and understanding of telemedicine integration.
- Telemedicine, specifically Tele-ICU, offers support to bedside intensive care unit (ICU) providers.
Purpose of the Study:
- To characterize documented interactions between bedside ICU providers and teleintensivists using a standardized note template.
- To analyze the utilization patterns and initiation of Tele-ICU support.
Main Methods:
- A retrospective analysis of documented interactions in two Veterans Health Administration ICU telemedicine support centers.
- Data collected from October 2012 to September 2014, assessing initiation site, initiator, contact type, and patient care changes.
Main Results:
- Teleintensivist interaction was documented in 21.6% of 14,511 ICU admissions.
- Most interactions (74.4%) were initiated by bedside staff, with increasing use over time.
- Bedside nurses initiated the majority (84.3%) of contacts that resulted in patient care changes.
Conclusions:
- Standardized note templates are valuable for documenting Tele-ICU interactions and clarifying telemedicine's role.
- Bedside staff, particularly nurses, are key users and drivers of Tele-ICU interventions.
- Future research should incorporate Tele-ICU utilization data into evaluations of its impact on patient outcomes.