title: Telemedicine in a Dutch intensive care unit: A descriptive study of the first results.
abstract: BACKGROUND
  Tele-intensive care (teleIC) can be used to increase the level of care in the intensive care unit (ICU) with the tele-intensivist being at a remote site. In this study we describe the implementation and outcomes, including patient and family satisfaction, of the first Dutch teleIC.
  
  
  METHODS
  In a retrospective analysis the patient characteristics are described with a focus on patient outcomes and patient and family satisfaction. The teleIC started on 6 December 2010 in an ICU with three beds. Data for all admitted patients were collected from 1 January 2011 through 31 December 2013 from available systems. Severity of disease (APACHE IV) and standardized mortality ratios (SMR) were available over the complete calendar years 2012 and 2013. A prospective self-made survey of patient and family satisfaction was performed over a 14-month period after the implementation of teleIC.
  
  
  RESULTS
  In 2012 and 2013, 556 patients were admitted. The number of operating room recovery patients in the ICU declined over time. One hundred and seven patients were transferred to a higher-level ICU (19%). The SMR for non-transferred patients was 0.73 (95% CI (confidence interval) 0.54-0.98) and 0.66 (95% CI (confidence interval) 0.40-1.02) for transferred patients. These numbers are in line with national data. Thirty-six percent of family and 38% of the patients responded to the survey and showed a positive response concerning communication within the tele IC setting.
  
  
  CONCLUSIONS
  Implementation of teleIC in a Dutch situation was successful and showed favourable results in patient outcomes and the satisfaction of patients and family members.
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands TIAS School for Business and Society, Tilburg University, Tilburg, The Netherlands p.h.j.vandervoort@olvg.nl.
authors.forename: Peter H J
authors.initials: PH
authors.lastname: van der Voort
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Jesse
authors.initials: J
authors.lastname: de Metz
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Jos P J
authors.initials: JP
authors.lastname: Wester
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Ilse
authors.initials: I
authors.lastname: van Stijn
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Hilde Marieken
authors.initials: HM
authors.lastname: Feijen
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Anja
authors.initials: A
authors.lastname: Balzereit
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Rijkenberg
authors.affiliation: Department of Intensive Care, Medisch Centrum Zuiderzee, Lelystad, The Netherlands.
authors.forename: Renate
authors.initials: R
authors.lastname: Obster
authors.affiliation: Deptartment of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: Bosman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods* / Q000592:standards; D005190:Family / Q000523:psychology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods / Q000592:standards
keywords: Netherlands; Telemedicine; intensive care; outcome; satisfaction; teleIC