Telemedicine in Intensive Care Units: Protocol for a Scoping Review

Abstract

Background Telemedicine has been deployed to address issues in intensive care delivery, as well as to improve outcome and quality of care. Implementation of this technology has been characterized by high variability. Tele-intensive care unit (ICU) interventions involve the combination of multiple technological and organizational components, as well as interconnections of key stakeholders inside the hospital organization. The extensive literature on the benefits of tele-ICUs has been characterized as heterogeneous. On one hand, positive clinical and economical outcomes have been shown in multiple studies. On the other hand, no tangible benefits could be detected in several cases. This could be due to the diverse forms of organizations and the fact that tele-ICU interventions are complex to evaluate. The implementation context of tele-ICUs has been shown to play an important role in the success of the technology. The benefits derived from tele-ICUs depend on the organization where it is deployed and how the telemedicine systems are applied. There is therefore value in analyzing the benefits of tele-ICUs in relation to the characteristics of the organization where it is deployed. To date, research on the topic has not provided a comprehensive overview of literature taking both the technology setup and implementation context into account. Objective We present a protocol for a scoping review of the literature on telemedicine in the ICU and its benefits in intensive care. The purpose of this review is to map out evidence about telemedicine in critical care in light of the implementation context. This review could represent a valuable contribution to support the development of tele-ICU technologies and offer perspectives on possible configurations, based on the implementation context and use case. Methods We have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and the recommendations of the Joanna Briggs Institute methodology for scoping reviews. The scoping review and subsequent systematic review will be completed by spring 2021. Results The preliminary search has been conducted. After removing all duplicates, we found 2530 results. The review can now be advanced to the next steps of the methodology, including literature database queries with appropriate keywords, retrieval of the results in a reference management tool, and screening of titles and abstracts. Conclusions The results of the search indicate that there is sufficient literature to complete the scoping review. Upon completion, the scoping review will provide a map of existing evidence on tele-ICU systems given the implementation context. Findings of this research could be used by researchers, clinicians, and implementation teams as they determine the appropriate setup of new or existing tele-ICU systems. The need for future research contributio...

Telemedicine in Intensive Care Units: Scoping Review

“…A research protocol for this review was published in JMIR Research Protocols in December 2020 [ 11 ], which was developed in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and best practices advanced by Arksey and O’Malley [ 18 ] and the Joanna Briggs Institute [ 19 ]. The method included the steps identification of relevant studies , selection of study , data charting , and data collating .…”

“…A significant body of primary and secondary literature has been published on ICU telemedical interventions [ 10 ]. To date, 9 systematic reviews and 9 other review types have been published on this topic [ 11 ], as well as 3 meta-analyses with a focus on medical outcomes (eg, hospital mortality and length of stay) [ 12 ]. In previous reviews, the results of tele-ICU interventions have been characterized as heterogeneous [ 13 , 14 ].…”

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“…Consequently, the consultants can prevent fixation errors or provide a more valid proposal (ID4, ID13). This effect is equally discussed in telemedicine literature (Guinemer et al, 2020;Lupton & Maslen, 2017). Lupton and Maslen (2017) emphasize the introduction of sensors for patient telemonitoring, whereas Guinemer et al (2020) describe the efficiency of a telemonitoring dashboard.…”

“…This effect is equally discussed in telemedicine literature (Guinemer et al, 2020;Lupton & Maslen, 2017). Lupton and Maslen (2017) emphasize the introduction of sensors for patient telemonitoring, whereas Guinemer et al (2020) describe the efficiency of a telemonitoring dashboard. On a more general level, Strong et al (2014) outline the positive effect of IT artifacts on physicians' behavior and actions, such as knowledge sharing.…”

“…Some physicians called others within their network and asked for an assessment via phone. Other physicians applied videoconferencing tools to exchange information with a colleague via camera or to show the patient's health status via a dashboard (Bokolo, 2021;Guinemer et al, 2020). These scenarios present some examples of the use of different telemedical applications in virtual hospitals, and similarly show the intensified physicians' intent to use technology (Sitammagari et al, 2021).…”