Tele-intensive care (tele-ICU) is a type of Doctor-to-Doctor (D to D) telemedicine in which doctors support their medical treatment using video/audio calls and computer systems. This is a remote consultation service for treatment.In the United States, it has been introduced in about 28% of hospitals, and it has been shown to be effective in lowering mortality rates and shortening hospital stays, but in Japan, remote intensive care has only been introduced in a small number of cases.
This time, a research group led by Mizuki Morimoto, a medical student at Tokyo Medical and Dental University, Professor Masanaga Yamawaki, and Associate Professor Nobutoshi Nanami of the same university, aimed to clarify the needs for remote intensive care from the perspective of doctors in the medical field in Japan. analyzed the ``reason for consultation'' and ``the content of advice sought by the on-site doctor'' during remote intensive care.The method was to use on-site doctors who do not specialize in intensive care (a total of 5 people from 26 secondary medical institutions in the Kansai-Chubu region) recorded by T-ICU (currently Vitaars), which provides remote intensive care. This was a qualitative study in which the audio data of consulting physicians' telephone and video consultations (2019/12 to 2021/4, total of 70 cases, total of 15 hours) was recorded verbatim and thematic analysis was conducted.
As a result, the reasons why on-site doctors decided to consult remotely were ``personal factors related to treatment and response,'' such as when treating patients outside of their specialty or when treatment plans become complicated, and because there was no one on site to consult with. ``Factors related to the relationship between the on-site doctor and others,'' such as cases, were frequently observed.
The most common type of advice that on-site physicians sought from consulting physicians was advice on treatment, followed by patient triage and transportation, diagnosis, and diagnostic tests and evaluation of results.These can be thought of as the needs that field doctors seek for remote intensive care.
In medical settings where the resources of intensive care specialists are limited, remote intensive care may be a solution.The findings obtained in this study have clarified the current status and issues of remote intensive care and medical practice in Japan, and are expected to provide the information necessary for the spread and quality improvement of remote intensive care in the future.
Paper information:[BMJ Open] Elucidation of the needs for telecritical care services in Japan: A qualitative study
