Remote access to critical care

As we all begin to focus more on errors in medicine, telemedicine applications will expand. Remote access to experts will be required. Although telemedicine has always existed as a component of medicine, it was usually designed for niche areas. Telemedicine consists of information sharing between at least two physically and geographically disparate sites for educational or health purposes. Although telemedicine in the intensive care unit may at first seem absurd to many clinicians, most care providers have, in fact, used some form of telemedicine to provide care for decades. All of us have managed patients by telephone communication with nurses, residents, or other physicians. Besides augmenting routine care in the intensive care unit, telemedicine is providing essential tools that improve the efficiency of health care communication and add safety for the health care provider by making health care available under less than ideal circumstances, such as a terrorist attack with biologic weapons. The future appears quite bright for telemedicine systems, but much work is still required. How payers, lawyers, and ethicists view telemedicine is not yet completely understood. As intensivists, we should expect our practice to be directly impacted by this maturing technology. We should wholeheartedly embrace it and help lead its use in this new millennium.