Tele-ICU care also benefits physicians

Interview with Prof. Thea Koch, President of the German Society for Anesthesiology and Intensive Care Medicine (German: Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin e.V.)

Tele-ICU care with which the U.S. has already had excellent experiences is meant to also be implemented in Germany so facilities are able to provide their patients with optimal care.


Photo: Smiling woman with shulder long, dark hair - Thea Koch

Prof. Thea Koch; ©Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden spoke with Prof. Thea Koch, President of the German Society for Anesthesiology and Intensive Care Medicine about this subject.

Professor Koch, what makes telemedicine so special for intensive care patients? Surely, it has always been possible to ask colleagues for help with difficult problems.

Thea Koch: This is the typical mode of operation, of course, yet tele-ICU care is about so much more. Our goal is not just to give or receive selective advice. This is about the treatment of critically ill patients with the help of the latest technology, which enables direct video transmission of the patient’s condition via video and audio connections as well as provides insights into current imaging. Without it, access to the expertise of specialists at centers and university hospitals would be impossible for smaller hospitals.

We have an increasing number of critically ill patients, thanks to the demographic development. Yet there is a discrepancy between capacity needs and the available resources at acute care inpatient beds and the need for qualified and experienced critical care physicians. To ensure comprehensive high-quality care, tele-ICU services, therefore, offer the chance to transfer expertise from the centers into many hospitals. It isn’t always possible, for example, to relocate a patient to a specialty hospital, due to reasons of capacity or because the patient is unstable. This is why round the clock treatment based on guidelines and the current standards can be guaranteed thanks to tele-ICU care.

What other advantages does tele-ICU care offer?

Koch: The treatment outcome, meaning the patient’s state of health, strongly depends on how consistently and timely he or she was being treated. These “virtual” doctor visits can be very helpful as studies in the U.S. have already shown. The death rate, complication rate and length of stay in the intensive care unit were significantly reduced thanks to tele-ICU services. This in turn leads to a reduction in total treatment expenses. Physicians also benefit from tele-ICU care since they can learn from experts outside of their own facility and use their expertise in the event of declining health in the patient. This way, they are able to initiate appropriate measures in a much faster and more targeted manner.

Is telemedicine in the intensive care unit intended for all patients or just for specific groups?

Koch: Technically speaking, you can care for all patients this way, but the goal is to treat critically ill patients using telemedicine systems. This pertains to patients who suffer from organ failure, septic shock or multiple traumatic injuries for instance.

What is the cost for this type of special care?

Koch: You need to employ experienced specialists at the respective centers with additional certification in critical care medicine who are available for consultations around-the-clock. Of course, this is only profitable when several hospitals are connected to the system and the treatment expenses can be reduced thanks to faster and better patient therapy.

The RWTH Aachen University is currently conducting a study on this subject. When can we expect a study report?

Koch: The data collection phase of the project is still operating until the end of July, and we expect first findings in October. This is where the Americans, who were able to show impressive improvements in treatment outcomes using telemedicine systems, are one step ahead of us. You might say that no pharmacological or medical technology innovation has shown a comparable medical and economical result in the U.S. than the introduction of tele-ICU services.

That all sounds very promising. When do you expect comprehensive telemedicine implementation in Germany?

Koch: We are still in the early stages. We still cannot say when tele-ICU care will become a part of reimbursement structures to be implemented comprehensively. We issued our association’s structure recommendations pertaining to tele-ICU care in May. This publication maps out the basic principles, indications, requirements and data protection conditions. Now it needs to prove successful in its application and show that a respective remuneration can cover personnel costs and investments. I think realistically, it will still take about ten years until we can expect comprehensive tele-ICU care implementation.
Photo: Simone Ernst; Copyright: B. Frommann

© B. Frommann

The interview was conducted by Simone Ernst and translated by Elena O'Meara.