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

Area of Science:

• Healthcare Systems
• Telemedicine
• Critical Care

Background:

• The COVID-19 pandemic strained U.S. healthcare, highlighting ICU bed limitations.
• Telemedicine, specifically tele-critical care (TCC), offers a solution to expand clinical capabilities and capacity.
• Rapid TCC deployment faced significant implementation barriers.

Purpose of the Study:

• To identify barriers to the National Emergency Tele-Critical Care Network (NETCCN) deployment.
• To propose strategies for overcoming these barriers.
• To outline a minimum, better, best paradigm for TCC delivery during national disasters.

Main Methods:

• Convened over 50 national leaders in telemedicine and critical care.
• Experts shared opinions on NETCCN implementation barriers and solutions.
• Developed white papers based on expert consensus to form the article's basis.

Main Results:

• Cross-state licensure and local privileging of virtual experts are the primary barriers to rapid TCC deployment.
• Refining TCC models for optimal outcomes and establishing sustainable financial models are crucial for long-term success.
• A national telemedicine response system is deemed achievable.

Conclusions:

• Overcoming legal, policy, and cultural barriers is essential for effective TCC implementation.
• A structured approach (minimum, better, best) can guide TCC delivery.
• A rapidly deployable national telemedicine system is feasible and necessary.