[Avoiding Long-term Impairment in Critical Care Using Telemedicine: The ERIC Example].

Area of Science:

• Critical Care Medicine
• Health Services Research
• Digital Health

Background:

• Rising demand for critical care services strains resources and intensifies challenges due to increasing patient complexity and a shortage of intensivists.
• Telemedicine offers a solution for efficient resource utilization, improved adherence to best practices, and enhanced quality of care in critical care settings.
• Previous studies indicate telemedicine's effectiveness in reducing mortality and length of stay in intensive care units.

Purpose of the Study:

• To pilot a novel telemedicine-based critical care delivery model in Germany through the Enhanced Recovery after Intensive Care (ERIC) trial.
• To enhance adherence to evidence-based and consensus-based quality indicators for acute critical care using telemedicine.
• To assess long-term patient outcomes, including impairments and post-intensive care syndrome, through intersectoral case-care management post-discharge.

Main Methods:

• A multicenter, pragmatic, stepped wedge cluster-randomized controlled quality improvement trial design.
• Implementation of a telemedicine program involving experienced intensivists and well-functioning equipment.
• A target study sample size of 1431 patients, with follow-up at three and six months post-intensive care unit discharge.

Main Results:

• The study aims to demonstrate increased adherence to critical care quality indicators.
• Expected outcomes include improved patient outcomes and efficient resource allocation.
• The trial will provide insights into the acceptance and effectiveness of telemedicine among on-site clinicians.

Conclusions:

• Telemedicine holds significant potential to address challenges in critical care provision.
• The ERIC trial is expected to provide robust evidence on the benefits of telemedicine in improving critical care quality and patient recovery.
• Long-term patient monitoring will offer valuable data on the sustained impact of intensive care interventions and telemedicine support.