ICU Multipoint Military Pacific Consultation using Telehealth (IMMPACT)

Abstract : Critical care specialist shortages have been identified as a critical physician manpower issue in the United States, and standards for availability of critical care specialists demand alternate solutions to continuous on-site critical care specialists. Telemedicine is one model of healthcare delivery which by design may address the shortage of critical care specialists, and has been variably reported to show significantly improved outcomes in clinical and process domains in some reports, and recently as showing no significant mortality differences in pooled data analysis. This project was designed to install, and operate a remote critical care consultation service by a remote telemedicine system between a hub at Tripler Army Medical Center (TAMC) in Honolulu, Hawaii and two remote intensive care units, at small military treatment facilities outside of the continental United States (OCONUS). Critical care specialists are not routinely assigned to the remote facilities. Critical care specialists are available at TAMC to provide consultative services. The remote facilities are Naval Hospital, Guam (NHG), and Brian Allgood Community Hospital (BAACH) in Seoul, South Korea. BAACH was renamed during the interval of this project, and is specified as the US Army 121 Combat Support Hospital in the contract documents. The project research objectives were focused on demonstrating a practical approach to delivery of critical care consultation by telemedicine using a commercially available critical care telemedicine system, eICU . The project partner for provision of the eICU system was specified as VISICU, Inc (Baltimore MD). VISICU, Inc was acquired during this project, and is now managed as Philips VISICU. The eICU system was utilized in this project for delivery of clinical services and for the conduct of research.