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Telehealth Can Be a Useful Communication Tool in the ICU

A Penn Medicine study finds that a video-based telehealth platform could improve communications between clinicians and a patient's family members in the always-busy ICU.

By Eric Wicklund

- A telehealth link could be more beneficial to clinicians than a room full of family members in the ICU, according to a new study.

Conducted by researchers at the University of Pennsylvania, the study finds that a videoconference link to family members could benefit both clinicians and family, primarily by reducing bedside hassles and distractions and giving clinicians an easier means of talking with family members.

“A telemedical platform would increase the ability of family members to participate virtually in ICU rounds as well as stay informed throughout the day when it is not possible for them to be physically present,” says Daniel Holena, MD, FACS, an assistant professor of surgery at the Perelman School of Medicine at the University of Pennsylvania at Philadelphia and lead author of the study. “This might allow for better overall communication between healthcare providers and family members responsible for making decisions about medical care, in some cases leading to earlier discussions regarding the overall goals of care for critically ill patients.”

The study appears in the September 2016 issue of the American Journal of Critical Care (AJCC).

While research indicates more than 85 percent of families prefer to be at a relative’s bedside in the ICU, Holena and Elisabeth A. Stelsen, MSW, MPH, interviewing family members as well as ICU clinicians, found that the complex, fast-moving ICU environment can also pose problems.

Family members might not be comfortable asking questions of a busy doctor or nurse, or they might not understand the medical terminology in the prognosis. And they’re usually in a heightened state of distress that affects how they communicate and understand what they’re being told.

Separate surveys have also found that doctors and patients sometimes prefer speaking via video feed than in person, as it compels both parties to listen more carefully. A telehealth platform could also better incorporate translators when needed.

The Penn Medicine study also found that family members might also have difficulty travelling to and from the hospital, due to distance, work and other obligations, and therefore might not be available when doctors are making rounds. This is especially true when a patient is confined to the ICU for a long period of time.

A telehealth link could allow family members to see what’s going on in the ICU without getting in the way, and would enable clinicians to ask and answer questions and provide updates without interrupting workflows.

“Family participation in ICU rounds is an important tool to refocus delivery of care around the needs of patients, but there is little literature about it and the practice is often inconsistent.” Holena said in a news release accompanying the study. “By identifying barriers and exploring solutions, we can encourage adoption of family-centered rounds in more ICUs.”

Design and placement of the technology are also important, says Holena.

“To be effective, this platform would need to be reliable, easy to use, and compliant with health information and patient privacy regulations.,” he says. “Ideally, the applications necessary for the patient’s family members to participate remotely would be easy to install and set up for use on a smartphone or other device.”

“To eliminate disparities in the use of this technology, devices would need be made available by the health system for use by patient family members while the patient was in the ICU,” he adds. “Reliability and ease of use would also need to be coupled with training as necessary to ensure family members were prepared to participate remotely.”

“Ideally, this platform would be integrated into the existing infrastructure, information technology and technical support resources of the health system,” Holena adds. “Since the primary concern in the ICU is always patient care, ‘one button’ functionality would be a must, as providers do not have the time or technical expertise to troubleshoot logistical issues.”

Dig Deeper:

Virtual Care Within the EHR May Be a ‘Game-Changer’

Telemedicine Survey Shows Strong Support From ICU Nurses

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