title: Telemedicine in critical care: an experiment in health care delivery.
abstract: We hypothesized that telemedicine -- medicine practiced from a distance using telecommunications -- can solve some problems related to the scarcity and maldistribution of specialists in critical care medicine. Using a two-way audiovisual link between a small private hospital and a large university medical center, we have provided daily consultations by an intensivist to patients in the small institution. During the first 175 days of the project we found: 1) regular consultations in critical care can be provided using the audiovisual link; 2) current technology is adequate but expensive; 3) telemedicine consultations can be made acceptable to users and providers; 4) telemedicine can be a valuable educational resource; 5) telemedicine can influence the process and probably the outcome of patient care; 6) the audiovisual link is superior to the telephone for these consultations; and 7) telemedicine can serve as an important link between a small hospital and a large medical center favorably influencing the quality of care in the critical care unit of the small hospital.
mesh_terms: D001296:Audiovisual Aids; D003422:Critical Care; D003695:Delivery of Health Care; D006801:Humans; D008511:Medicine; D009820:Ohio; D011787:Quality of Health Care; D012017:Referral and Consultation; D013038:Specialization; D013685:Telecommunications; D013689:Telephone