ArticleAmerican journal of respiratory and critical care medicine2019
Determinants of Intensive Care Unit Telemedicine Effectiveness. An Ethnographic Study.
Article in American journal of respiratory and critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinicians' and patients' views and experiences on virtual hospital care: a systematic review of qualitative evidence.BMJ health & care informatics · 2026Pooled it
- Healthcare stakeholders' perceptions and experiences of factors affecting the implementation of critical care telemedicine (CCT): qualitative evidence synthesis.The Cochrane database of systematic reviews · 2021Pooled it
- Evaluation of the clinical impact of different telemedicine practices in intensive care units: A stepped-wedge cluster randomized clinical trial (TELESCOPE 2): Study protocol.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Article
- Clinicians' Approaches to Prognostication After Traumatic Brain Injury and Cardiac Arrest: A Multi-Hospital, Qualitative Study.Neurocritical care · 2026Article
- Artificial intelligence assisted telemedicine, clinical decision support for anesthesia and critical care in intensive care units: a scoping review.BMC anesthesiology · 2026Article
- Assessment of Structured Tele-Critical Care Training and Its Impact on Clinician's Perceptions of Delivery of Care: A Survey-Based Pilot Study.Critical care explorations · 2026Article
- Optimising time-limited trials in acute respiratory failure: a multicentre focused ethnography protocol.BMJ open · 2025Article
- Telemedicine critical care availability and outcomes among mechanically ventilated patients.Journal of critical care · 2024Article
- Targets for De-implementation of Unnecessary Testing Before Low-Risk Surgery: A Qualitative Study.The Journal of surgical research · 2024Article
- Telemedicine Critical Care-Mediated Mortality Reductions in Lower-Performing Patient Diagnosis Groups: A Prospective, Before and After Study.Critical care explorations · 2023Observational
- Teleneurocritical Care for Patients with Large Vessel Occlusive Ischemic Stroke Treated by Thrombectomy.Neurocritical care · 2023Article
- Integrating a Virtual ICU with Cardiac and Cardiovascular ICUs: Managing the Needs of a Complex and High-Acuity Specialty ICU Cohort.Methodist DeBakey cardiovascular journal · 2023Review
- Building Critical Care Capacity in a Low-Income Country.Critical care clinics · 2022Review
- Leadership in the context of digital health services: A concept analysis.Journal of nursing management · 2022Article
- Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.Resuscitation · 2022Article
- Pilot of rapid implementation of the advanced practice provider in the workflow of an existing tele-critical care program.BMC health services research · 2022Article
- Teleneurocritical Care: Lessons Learned in Standardizing Care.Neurocritical care · 2022Article
- Operation analysis of the tele-critical care service demonstrates value delivery, service adaptation over time, and distress among tele-providers.Frontiers in medicine · 2022Article
- Telemedicine in Intensive Care Units: Scoping Review.Journal of medical Internet research · 2021Article
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Authors and funding
9 authors.
Funding
Abstract
rationaleTelemedicine is an increasingly common care delivery strategy in the ICU. However, ICU telemedicine programs vary widely in their clinical effectiveness, with some studies showing a large mortality benefit and others showing no benefit or even harm.
objectivesTo identify the organizational factors associated with ICU telemedicine effectiveness.
methodsWe performed a focused ethnographic evaluation of 10 ICU telemedicine programs using site visits, interviews, and focus groups in both facilities providing remote care and the target ICUs. Programs were selected based on their change in risk-adjusted mortality after adoption (decreased mortality, no change in mortality, and increased mortality). We used a constant comparative approach to guide data collection and analysis. MEASUREMENTS AND MAIN
resultsWe conducted 460 hours of direct observation, 222 interviews, and 18 focus groups across six telemedicine facilities and 10 target ICUs. Data analysis revealed three domains that influence ICU telemedicine effectiveness: 1) leadership (i.e., the decisions related to the role of the telemedicine, conflict resolution, and relationship building), 2) perceived value (i.e., expectations of availability and impact, staff satisfaction, and understanding of operations), and 3) organizational characteristics (i.e., staffing models, allowed involvement of the telemedicine unit, and new hire orientation). In the most effective telemedicine programs these factors led to services that are viewed as appropriate, integrated, responsive, and consistent.
conclusionsThe effectiveness of ICU telemedicine programs may be influenced by several potentially modifiable factors within the domains of leadership, perceived value, and organizational structure.
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