title: Identification of tele-ICU system requirements using a content validity assessment.
abstract: OBJECTIVE
  Telemedicine in intensive care (tele-ICU) involves the use of information technologies to deliver care instructions from a command center to remote hospitals. To ensure acceptance and usability, clinicians should participate early in the design. This study surveyed clinical professionals to identify and rank important functions for a tele-ICU system.
  
  
  METHODS
  This cross-sectional, prospective, structured, two-round survey included European intensive-care professionals that were not familiar with tele-ICU systems. In the first round, statements of system function specifications were evaluated for validity; in the second round, unclear items were rephrased and new items were added. Item-level content validity indexes (I-CVI) were calculated, and values above a 0.75 threshold were considered relevant. Weighted ranking points (WRP) was calculated from the ranking data.
  
  
  RESULTS
  A total of 26 responses were received from professionals for four European countries; the majority were intensive-care specialists (77%). A total set of 50 items were selected for the survey. Thirty-six functional specifications were identified with I-CVIs above 0.75, including online access to all patient data (13 items), related risks and alarms (8 items), audio-visual contact for consultations and for monitoring patient beds (5 items), information security (5 items), and resource allocation (5 items). The highest ranking system functions were real time monitoring, alarms, audio-visual connections, and data security.
  
  
  CONCLUSIONS
  Professionals not familiar with tele-ICUs regarded full patient data access, alarms, data security, and audio-visual connections the most important functions in pre-implementation phase.
authors.affiliation: Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu, Oulu University, Oulu, Finland.
authors.forename: Simo
authors.initials: S
authors.lastname: Larinkari
authors.affiliation: Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu, Oulu University, Oulu, Finland. Electronic address: janne.liisanantti@ppshp.fi.
authors.forename: Janne H
authors.initials: JH
authors.lastname: Liisanantti
authors.affiliation: Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu, Oulu University, Oulu, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Ala-Lääkkölä
authors.affiliation: Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu, Oulu University, Oulu, Finland; Institute of Health Science, University of Oulu, Oulu, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Meriläinen
authors.affiliation: Institute of Health Science, University of Oulu, Oulu, Finland.
authors.forename: Helvi
authors.initials: H
authors.lastname: Kyngäs
authors.affiliation: Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu, Oulu University, Oulu, Finland.
authors.forename: Tero
authors.initials: T
authors.lastname: Ala-Kokko
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003422:Critical Care / Q000458:organization & administration* / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D061214:Patient Safety; D011446:Prospective Studies; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D017216:Telemedicine
keywords: Content validity assessment; Tele-ICU; Telemedicine