title: [Telemedicine: Improving the quality of care for critical patients from the pre-hospital phase to the intensive care unit].
abstract: The Health System is in crisis and critical care (from transport systems to the ICU) cannot escape from that. Lack of integration between ambulances and reference Hospitals, a deep shortage of critical care specialists and assigned economical resources that increase less than critical care demand are the cornerstones of the problem. Moreover, the analysis of the situation anticipated that the problem will be worse in the future. "Closed" ICUs in which critical care specialists direct patient care outperform "open" ones in which primary admitting physicians direct patient care in consultation with critical care specialists. However, the current paradigm in which a critical care specialist is close to the patient is in the edge of the trouble so, only a new paradigm could help to increase the number of patients under intensivist care. Current information technology and networking capabilities should be fully exploited to improve both the extent and quality of intensivist coverage. Far to be a replacement of the existing model Telemedicine might be a complimentary tool. In fact, to centralize medical data into servers has many additional advantages that could even improve the way in which critical care physicians take care of their patients under the traditional system.
authors.affiliation: Unidad de Cuidados Intensivos, Clínica Bazterrica y Clínica Santa Isabel, La Plata, Buenos Aires, Argentina.
authors.forename: G
authors.initials: G
authors.lastname: Murias
authors.forename: B
authors.initials: B
authors.lastname: Sales
authors.forename: O
authors.initials: O
authors.lastname: García-Esquirol
authors.forename: L
authors.initials: L
authors.lastname: Blanch
mesh_terms: D056902:Clinical Alarms; D003195:Computer Communication Networks / Q000458:organization & administration; D003194:Computer-Assisted Instruction; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics / Q000379:methods*; D004632:Emergency Medical Services / Q000191:economics / Q000379:methods*; D004635:Emergency Medicine / Q000191:economics / Q000193:education / Q000379:methods*; D005544:Forecasting; D006301:Health Services Needs and Demand; D006747:Hospital Communication Systems / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000458:organization & administration*; D008991:Monitoring, Physiologic / Q000191:economics / Q000295:instrumentation; D011785:Quality Assurance, Health Care; D011786:Quality Control; D013030:Spain; D017216:Telemedicine / Q000191:economics / Q000458:organization & administration / Q000639:trends; D000078329:Workforce