Tele Critical Care (TCC) in our Challenging Healthcare Times: Optimize Resources and Patient Outcomes – Dr. Paul Langlois

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As the surge of COVID-19 patients is taking place, ICU beds are in short supply. ICU teams are pushed to the limit. Not to mention that protective equipment and ventilators that are just not available to meet current patient demands. Hospitals are facing incredible challenges, that require creative solutions for the life-threatening needs of coronavirus patients, as well as the other ICU/CCU patients who still require complex lifesaving care as well. Tele Critical Care is an essential option that is helping to match the current critical needs of patients with the intense demands on healthcare staff.

Dr. Paul Langlois, APN, PhD, CCRN, CCNS, CNRN, is a critical care clinical specialist who has extensive experience using telemedicine in the CCU and Trauma ICUs of Cook County Hospital in Chicago. He understands the stress that many ICU/CCU care providers are experiencing and wants to share the patient care insights he has accrued through this model of care delivery. Dr. Langlois will highlight best practices regarding staffing structures, coordination of care within a larger healthcare system, triaging patient care, virtual strategies to reduce mortality, the financial/legislature/licensure barriers….and more!

Dr. Langlois understands your days and nights are as busy as his. It might feel impossible to find spare time right now. However, in just 90 minutes….you will take away essential considerations to initiate or enhance your own hospital’s Tele Critical Care program. During this recording, Dr. Langlois will deliver actual solutions to the ICU/CCU challenges you are experiencing today.

1. Evaluate the effectiveness of the various methods of telemedicine.
2. Categorize three barriers to telemedicine adoption.

Emerging Trends in Tele-Critical Care (TCC)

• Centralized hub and spoke structure
• Decentralized program structure
• Hybrid program structure

Staffing Structures

• Personnel (employed or contracted)
• Nurses/APN
• Physicians

Tele-Critical Care Organizations

• Multiple ICUs within a single healthcare system
• Triage system to get patient to appropriate level of care
• Serve as resource to other healthcare system

Tele-Critical Care Outcomes

• Sepsis management (treat faster than conventional healthcare)
• Reduction in mortality (reduced mortality versus conventional)
• Staff support (higher staff satisfaction)

Address the Barriers to TCC

• Financial (return on investment)
• Shift in responsibility and negligence (who is ultimately responsible for the patient)

Licensure and Credentialing

• CMS: Provider licensure in the state they practice
• VA practitioners can practice in any state
• Is there interstate cooperation
  • 21 states have physician cooperation
  • 29 states have nurse cooperation
  • 0 for pharmacists
• Credentialing requirements
• TCC requires specific telemedicine training – not just medicine or nursing care

Legislative Issues

• Growing legislation at federal and state level
• Video transmission of sensitive data
• Data sent to a non-secure smart phone

Future Directions

• Legal barriers
• More partnership
• Determine best practices

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