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The Impact of Telemedicine on Critical Care

The emergence of telemedicine critical care sector has encountered an enormous change in the past few years. Its advent has brought a great change and alteration to the delivery of clinical care and access to specialized expertise. This great medical invention has also proven its essence with more patient outcomes as a result of its impact on medical consultation. 

Telemedicine on Critical Care: A Modernize Care Impact

The effect of Telemedicine on critical care is an approach powered by technology, whose goal is centered on providing efficient medical treatment like remote patient monitoring, in the intensive care unit (ICU). Also, the introduction of a telemedicine network is to alleviate the increased scarcity of intensive care specialists and the escalating demand for telemedicine critical care services. 

This article will provide you with telemedicine diverse opportunities and challenges in ICU, various transformative natures of telemedicine critical care for patients, and strategic integration of telehealth with traditional ICU practice.

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Telemedicine in the  ICU: Opportunities and Challenges

Telemedicine is an advanced health tech that has greatly influenced critical care – Telehealth-IUC. It’s a system that’s rapidly evolving, with faster adoption and use. Telehealth-IUC is built for more and with more expectancy, explore with me as we unfold some of its opportunities and concerns.

Telemedicine Opportunities in the Intensive Care 

Technically and functionally, the impact of telemedicine on critical care has created diverse opportunities for integral care services and has gained remarkable recognition in the ICU. Some of these opportunities it provides are as follows: 

  • Quick Specialist Accessibility: With the help of telemedicine, intensive care patients have quick access to communicate with specialists at a remote distance to obtain specific knowledge. With quick specialist access, it enhances clinical settings most especially in urgent circumstances. 
  • Early Intervention and Decision-making: Telemedicine-IUC is a flexible system that possesses a great patient outcome caused by prompt intervention in a crucial expeditious setting. This flexible nature enables medical teams to quickly make decisions and communicate within themselves. 
  • Enhance Remote Monitoring: The impact of telemedicine in the intensive care units has granted medical professionals the ability to constantly monitor patients’ state of health remotely. It’s a very important element that can be used for neuromonitoring and with its immediate information seen to improve patient outcomes. 
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Various Challenges of Telemedicine Critical Care in ICU

With the high pace of telehealth development, standards, and healthcare advancement, some integral factors of great concern still need a touch of improvement. These various telehealth-ICU challenges are as follows: 

  • Security and Private Information Issues: Telemedicine in the intensive care unit involves the sharing of confidential patient data which are to be strictly protected and undisclosed.  This patient’s information is to be secured with proper adherence to medical regulations.
  • Need for Adaptation and Training: The need for a training program may be necessary for the proper utilization of telemedicine in the intensive care unit. Also, in some cases, there may be a slow rate of medical staff adaptation to the new tech system which may result in tactical change administration techniques. 
  • Technological Facilities Implementation; To utilize telehealth in the ICU effectively, a strong technological integration is greatly needed. The smooth implementation of technological facilities with telemedicine on critical care resources may cause some hurdles. 
  • Legal Barriers to Telemedicine Critical Care in ICU: Managing Medical Laws and Regulations may be difficult for an intensive care unit specialist. Telemedicine in the ICU for medical professionals has various barriers to conquer including the need for a license, liability concerns, and adherence to medical laws. 
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Case studies: Telemedicine Transforming Patient Care

The invention of telemedicine-ICU has played a great role in the transformative function of patient care. It’s earned a remarkable place in medical healthcare delivery with countless case studies over the past couple of years. Below are some case reports of telemedicine’s dramatic effect: 

Case Study 1: Telemedic Urban Health Service Project 

  • Background: Cooperative action between a medical neuroscience group and telemedicine clinics aimed at extending the provision of healthcare services to remote areas with medical inequities. 
  • Application: The neuroscience group provides portable technological telemedicine devices that help people in these remote areas gain access to experts, become diagnosed, and consult medical professionals. 
  • Result: The application of telemedicine critical care in this area fosters prompt intervention, and advancement in accessibility and also aids patients easy access to specialists.
  • Issues: some technical issues occurred due to limited network coverage which was scaled through with a satellite system. 
  • Conclusion: Telemedic Urban Health service provides extensive assistance to rural settlements with the help of telemedicine in critical care to break down distance barriers.

Case Study 2: Success in Managing Chronic Disease 

  • Background: A medical professional (intensivist) employed a telemedicine service to monitor a patient with chronic obstructive pulmonary disease (COPD). Aim to assist the patient in a post-surgery maintenance process. 
  • Application: The intensivist constantly reaches his patient via a telemedicine device to provide further instruction and monitoring guidelines about Non-invasive ventilation. 
  • Result: A successful patient outcome occurred as a result of the patient’s increased control rate. An increase in medical compliance and good health with continuous monitoring treatment. 
  • Issues: Corrective instructions and NIV device adjusting guidelines are done by the patient, obstructive network coverage causes a breakage in communication. 
  • Conclusion: The application of telemedicine devices causes effective chronic disease maintenance with the doctor having more opportunities to save lives remotely.
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Strategies for Integrating telemedicine with traditional ICU practice

Telemedicine in critical care has been a dynamic invention in the healthcare system that serves as a technical means of providing solutions for optimum patient care. It is a medical-tech innovation that can be integrated with traditional ICU practices to produce more patient outcomes. Below are some strategic ways of telemedicine-ICU integration: 

  • Remote Telemonitoring Application: Employ the use of a reliable patient monitoring application that will provide a remote health indicator for the intensivist. With the help of this telemonitoring system, ICU personnel can obtain current information that will allow prompt medical care. 
  • Modified Tele-ICU Procedure: Create a specialized procedure that allows easy incorporation of telemedicine with the ICU’s current procedures. Carefully dish out the responsibilities of each healthcare provider; either in remote settings or at the alpha location. 
  • Ensure Teleconsultation Provision: To protect patient data confidentially, facilitate the provision of a remote consultation with expertise, and ensure a more secure texting app and teleconferencing to improve coordination and knowledge sharing. 
  • Team Education and Training: Medical teams are to be equipped with telemedicine-related competencies. Also, funding for initiative training to teach intensivists about all telemedicine entails. 
  • Families and Patient Involvement: Employ various techniques that will encourage patients and their families to partake in virtual intensive care communication, allowing openness and assistance in emergency times. 
  • Multidisciplinary Cooperation: Develop a strong interaction among the telemedicine-ICU personnel e.g. physicians, specialists, ICU personnel, and lots more. 

The impact of Telemedicine on critical care has been an advanced technological solution incorporated into the medical sector for the increase of patient outcomes in ICU and generally the improvement in the healthcare system. Telehealth-ICU entails a wide range of opportunities and challenges but with a strategic implementation into traditional ICU practice, it radiates its essence as a transformative component of patient care. 

You can explore the incredible impact of telemedicine in contemporary healthcare today and discover a transformative remote patient outcome. Join the latest healthcare innovation today, and witness medical solutions at your comfort. 

References

Innovative Approaches: High-Flow Oxygen Therapy in the ICU

Innovative Approaches: High-Flow Oxygen Therapy in the ICU

Intensive Care Unit (ICU) is different, whereby individuals suffering from acute and critical respiratory conditions demand complex assistance. Mechanical ventilation has proved crucial for the medical care of these cases for decades. Mechanical ventilators are frequently used in pathological situations such as low oxygen levels or high carbon dioxide levels where the patient has difficulty breathing. Nevertheless, over recent years, there appears to be a new therapeutic way called high-flow oxygen therapy, which is likely to substitute or serve with traditional respiration practices. The goal is to create a particular focus on optimizing humidification to enhance patient comfort and respiratory support. 

High-Flow Oxygenation (HFO)

In clinical applications, oxygen therapy can be given as low flow (with mask or nasal cannula) or high flow (Venturi mask or nonrebreathers). However, in conventional methods, some of the oxygen inhaled by the patient is not delivered completely. Since the oxygen is not heated and humidified, the patient may not tolerate it for long periods. High-flow oxygen therapy, which is mainly used for respiratory diseases in pediatric patients, has found a serious place, especially in the COVID-19 pandemic and has begun to be widely used in adult patients as well.  

High-flow oxygen/cannula therapy is gaining widespread attention as an alternative approach to respiratory support in intensive care patients. This method is applied via air or oxygen mixer (rate up to 60 L/min at 21% to 100% oxygen fraction), humidifier, patient circuit and nasal cannula. The high-flow, warmed, humidified oxygen removes carbon dioxide from the anatomical dead space, making breathing easier and increasing patient comfort.

Benefits of HFO in ICU

The benefits of HFO go further than simple improvement in gas exchange. Compared to traditional mechanical ventilation, HFO offers numerous advantages:

  • Comfortable for patients: The nasal prongs are soft and small. Several studies stated that patient comfort is higher with HFNC than with a conventional nasal cannula or face mask
  • Warming and humidification of secretions: There is no chance for warming and heating oxygen when applying with a nasal cannula or face mask. In HFNC, oxygen is humidified and warmed before being administered to the patient. This increases the patient’s ability to tolerate treatment over a long period. This can facilitate the removal of mucus and other secretions from the airway. 
  • PEEP effect: Although the HFNC is an open system, the high-flow nasal cannula provides resistance to expiratory flow and increases airway pressure. PEEP decreases lung compliance, residual capacity reduction and elimination of refractory hypoxia. PEEP allows collapsed lung alveoli to open. It improves oxygenation and lung compliance.
  • High flow rate: Access to 60 L/min oxygen flow, which is not possible with normal oxygen devices, is possible with HFNO devices. Flow rate, humidity and temperature can be adjusted with the device. This allows the treatment to be adapted to the individual’s condition, increasing effectiveness.

Mechanism Of Action And Clinical Applications

Nasal high-flow therapy contributes to improving the fractionation of alveolar gases by reducing nasopharyngeal dead space. The expandability of the nasopharynx provides significant inspiratory resistance relative to expiratory effort.

HFNO provides adequate flow rates to accommodate inspiratory flow and thus significantly reduces the inspiratory resistance associated with the nasopharynx and thus eliminates the associated work of breathing. Delivery of heated and humidified oxygen to the respiratory organs increases pulmonary compliance and reduces metabolic load compared to dry and cold gas. The high flow in the nasopharynx provides positive tensile pressure to activate the lungs.

High flow oxygen therapy indicates for hypercapnic respiratory failure, hypoxemic respiratory failure, post-extubation, preintubation oxygenation, acute heart failure and sleep apnea. In pediatric patients, it is mainly indicated for bronchiolitis, but also for pneumonia, croup, asthma and post-extubation.

Patient-Centered Care and Comfort

Patient comfort and satisfaction in the rigorous conditions of the ICU are critical aspects of providing quality health care. From the patient’s perspective, HFO significantly reduces discomfort associated with traditional mechanical ventilation.

  • Reduced Discomfort: A soft nasal cannula and gentle airflow take away distress caused by the endotracheal tube, making patients more tolerant and less anxious.
  • Improved Communication: Additionally, the methodology enables patients to communicate freely with each other during their stay, which facilitates an improved atmosphere.
  • Enhanced Sleep Quality: Compared to mechanical ventilation, HFO allows for better rest and, consequently, better recovery of patients because it is less noisy and does not cause disruption.

Clinical Outcomes and Cost-Effectiveness

HFO therapy has been studied extensively and proven clinically beneficial. One of the most comprehensive studies investigating the effectiveness of nasal high-flow therapy is the Clinical Guideline published by the American College of Physicians. According to this guideline, compared to NIV, it has been shown to improve clinical outcomes as an initial treatment for acute respiratory failure and improve patient comfort by reducing re-intubation compared to standard oxygen therapy. It is stated that it causes fewer complications in patients than NIV or COT.

The effectiveness of HFNO in patients with hypoxia in acute heart failure was investigated in a retrospective cohort study. It has been stated that there is a better improvement in left ventricular parameters in patients receiving HFNO treatment compared to non-invasive positive pressure ventilation. It has been concluded that HFNO may be an ideal model, especially in hypoxemic AHF patients.

In another meta-analysis investigating the use of HFNO in anesthesia induction, it was compared with FMV. The use of HFNo for anesthesia induction has been shown to significantly improve oxygenation compared to FMV.

In addition to those mentioned above, many scientific studies are showing the effectiveness of HFNO.

Cost Savings

In a study conducted in England, the cost-effectiveness of HFNO use was investigated. Three different cost-effectiveness models were used in this study: the pre-intubation model and the post-extubation model in low-risk and high-risk patients. The use of HFNO in first-line treatment is reported to provide estimated savings of £469 per patient compared to standard oxygen therapy and £611 compared to NIV. NHF cost savings for the high severity subgroup were found to be £727 compared to standard oxygen and £1,011 compared to NIV.

For post-intubation low-risk patients, NHF provides an estimated cost saving of £156 compared to standard oxygen. The savings for post-intubation high-risk patients was stated to be £104.

Another study in infants with bronchiolitis compared low-flow oxygen therapy and HFNO therapy. In this study, treatment costs were found to be between $1786-3600 for HFNO, while these figures were found to be between $2175-5125 for standard treatment. Based on this, the cost-effectiveness of high-flow oxygen therapy can be demonstrated.

high-flow oxygen device

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References

  • Walter K. Mechanical Ventilation. JAMA. 2021;326(14):1452. doi:10.1001/jama.2021.13084
  • Heated and humidified high-flow nasal oxygen in adults: Practical considerations and potential applications, Robert C Hyzy, MD, Uptodate, Access time: Dec 2023
  • Huiying Gao, Lin Chen, Xiaofei Kang, High-Flow Nasal Cannula Oxygen Therapy in Patients With Acute Heart Failure: A Meta-analysis, The Journal for Nurse Practitioners, Volume 19, Issue 5,2023, https://doi.org/10.1016/j.nurpra.2023.104602.
  • Nishimura M. High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respir Care. 2016 Apr;61(4):529-41. doi: 10.4187/respcare.04577. PMID: 27016353.
  • Toffaletti JG, Rackley CR. Monitoring oxygen status. Adv Clin Chem 2016;77:103-24.
  • Emily Eaton Turner &Michelle Jenks (2017), Cost-effectiveness analysis of the use of high-flow oxygen through nasal cannula in intensive care units in NHS England, https://doi.org/10.1080/14737167.2018.1411804
  • Paula Heikkilä MSc, Leena Forma PhD, Matti Korppi MD, PhD (2016), High-flow oxygen therapy is more cost-effective for bronchiolitis than standard treatment—A decision-tree analysis, Pediatric Pulmonology, https://doi.org/10.1002/ppul.23467
  • Kevin Dysart, Thomas L. Miller, Marla R. Wolfson, Thomas H. Shaffer, Research in high flow therapy: Mechanisms of action, Respiratory Medicine, Volume 103, Issue 10,
  • 2009,Pages 1400-1405, https://doi.org/10.1016/j.rmed.2009.04.007.
  • Baldomero, A. K., Melzer, A. C., Greer, N., Majeski, B. N., MacDonald, R., Linskens, E. J., & Wilt, T. J. (2021). Effectiveness and Harms of High-Flow Nasal Oxygen (HFNO) for Acute Respiratory Failure: An Evidence Report for a Clinical Guideline by the American College of Physicians. Annals of Internal Medicine, 174(7), 952. https://doi.org/10.7326/M20-4675
  • Song, Jl., Sun, Y., Shi, Yb. et al. Comparison of the effectiveness of high-flow nasal oxygen vs. standard facemask oxygenation for pre- and apneic oxygenation during anesthesia induction: a systematic review and meta-analysis. BMC Anesthesiol 22, 100 (2022). https://doi.org/10.1186/s12871-022-01615-7
  • Tong, Xiao MDb; Tong, Ningning MDa; Yao, Feifei MDc; Yan, Jing MDd; Ci, Caizhe MDd,*. Clinical outcomes of high-flow nasal cannula oxygen therapy in acute heart failure patients with hypoxemia: A retrospective cohort study. Medicine 101(43):p e31124, October 28, 2022. | DOI: 10.1097/MD.0000000000031124