Using electronic medical record notes to measure ICU telemedicine utilization

Amy M.J. O'Shea, Mary Vaughan Sarrazin, Boulos Nassar, Peter Cram, Lynelle Johnson, Robert S Bonello, Ralph J. Panos, Heather S. Reisinger

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Given the complexity of high-acuity health care, designing an effective clinical note template can be beneficial to both document patient care and clarify how telemedicine is used. We characterized documented interactions via a standardized note template between bedside intensive care unit (ICU) providers and teleintensivists in 2 Veterans Health Administration ICU telemedicine support centers. All ICUs linked to support centers and providing care from October 2012 through September 2014 were considered. Interactions were assessed based on initiation site, bedside initiator, contact type, and patient care change. Of 14 511 ICU admissions with teleintensivist access, teleintensivist interaction was documented in 21.6% (N=3136). In particular, contacts were primarily initiated by bedside staff(74.4%), use increased over time, and of contacts resulting in changes in patient care, most were initiated by a bedside nurse (84.3%). Given this variation, future research necessitates inclusion of utilization in evaluation of Tele-ICU and patient outcomes.

Original languageEnglish (US)
Article numberocx029
Pages (from-to)969-974
Number of pages6
JournalJournal of the American Medical Informatics Association
Issue number5
StatePublished - Sep 2017

Bibliographical note

Funding Information:
Author contributions: AMJO had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. LJ contributed substantially to the development of the note template, and HSR was responsible for study design. All authors substantially contributed to the writing and critical review of the manuscript. Financial disclosures: This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development IIR 09-0336 and the Veteran Rural Health Center, Central Region. Dr Cram is supported by National Institute of Health awards: K24 AR062133 from the National Institute for Arthritis and Musculoskeletal and Skin Diseases and R01 AG033035 from the National Institute on Aging. Conflicts of interest: AMJOS, MVS, BN, PC, LJ, RB, RJP, and HSR have no conflicts of interest or financial disclosures. Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved.


  • Critical care
  • Intensive care units
  • Telemedicine
  • United States Department of Veterans Affairs
  • Veterans


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