SCCM Pod-479: Is Tele-Critical Care Medicine the Future of Healthcare?

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During the COVID-19 pandemic, hospitals implemented tele-critical care medicine to help patients while keeping staff safe from exposure. Now that patient care has gone back to normal, what is the role of tele-critical care medicine? Donald S. Prough, MD, FCCM, was joined by Krzysztof Laudanski, MD, PhD, FCCM, and Sonia S. Everhart, PharmD, BCPS, BCCCP, FCCM, during the 2023 Critical Care Congress to discuss how tele-critical care medicine was implemented during the COVID-19 pandemic and its continued benefits after the pandemic. Sonia S. Everhart, PharmD, BCPS, BCCCP, FCCM, is a clinical pharmacy specialist in critical care at Atrium Health in Charlotte, North Carolina, USA. Krzysztof Laudanski, MD, PhD, FCCM, is a senior associate consultant at the Mayo Clinic in Rochester, Minnesota, USA. This podcast is sponsored by Equum Medical and CLEW Medical.

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Transcript:

This podcast is sponsored by Equum Medical and CLEW Medical. Tele-ICU technology is revolutionizing critical care delivery, allowing healthcare professionals to remotely monitor and treat critically ill patients in real time. As a nationally recognized acute care clinical services company, Equum brings the people and processes to power hospital telehealth programs, optimizing patient flow and clinical access. CLEW’s AI-powered platform enhances critical care decision-making with FDA-cleared predictive insights and workflow accelerators. Equum and CLEW unite the people, processes, and technology to transform the high-acuity and critical care experience. Learn more about these companies at equummedical.com and clewmed.com.

Dr. Prough: Hello, and welcome to the 2023 Critical Care Congress edition of the Society of Critical Care Medicine Podcast. I’m your host, Don Prough. Today, I’m joined by Sonia Everhart, PharmD, BCPS, BCCCP, FCCM, and Krzysztof Laudanski, MD, PhD, FCCM, to discuss the future of tele-critical care medicine. Dr. Everhart is a critical care clinical pharmacy specialist at Atrium Health in Charlotte, North Carolina, USA. Dr. Laudanski recently moved to Mayo Clinic. Dr. Laudanski, tell us what your current position is.

Dr. Laudanski: Thank you very much. I work at the Mayo Clinic as a senior associate consultant. My duties are within the Department of Anesthesia and Critical Care, and I’m also tasked with developing the faculty and ICU program there.

Dr. Prough: Great. Welcome, Dr. Everhart and Dr. Laudanski. Before we start, do you have any disclosures to report?

Dr. Laudanski: No.

Dr. Everhart: No disclosures.

Dr. Prough: Thank you. I’m sure that many of our listeners will be familiar with the general concept of tele-critical care. What is the range of clinicians who provide tele-critical care services?

Dr. Laudanski: Traditionally, we have doctors, but more and more we have other healthcare providers. You see in the ICU respiratory therapists, pharmacists, nurses, advanced practice providers who join forces, and they’re trying to pretty much bring more comprehensive care through the tele-ICU environment. Sonia, for example here, works as a pharmacist. She should probably talk a little bit about her work. I developed a program at the University of Pennsylvania where we augment respiratory therapy services with the remote component using eRT and providing the care more safely and to more patients.

Dr. Prough: Tell us a little bit more about the tele-critical care pharmacy.

Dr. Everhart: Tele-critical care pharmacy was a grandchild of when I learned about the tele-critical care program that was being implemented at Atrium in Charlotte, North Carolina, as a way to enhance the critical care pharmacist reach to small hospitals in rural areas that don’t have access to a critical care-trained pharmacist. By being able to work remotely, I can see and touch and impact the medicational care for more patients than if I’m at the bedside. That’s how our program evolved, was adding us in. We started fairly small with a couple of hospitals and now cover eight facilities.

Dr. Prough: So you’re part of a tele-critical care team?

Dr. Everhart: I am part of a tele-critical care team. Atrium Health has, of course, physicians like Dr. Laudanski, and we also have APPs, and we also have virtual respiratory therapists there as well.

Dr. Prough: It sounds to me as if there are different services that tele-critical care can provide to different hospitals. It’s not one thing.

Dr. Laudanski: I think there’s a difference of, first of all, you can profile tele-ICU delivery to what the hospital needs. If the hospital is short on respiratory therapists, that’s when more virtual respiratory therapists are needed. That’s one of the great benefits of tele-ICU. The primary reason is that you don’t have physical constraint. You have somebody who sits in a remote location who may be deployed precisely when needed. That goes pretty much for all practice.

As Sonia said, in her location, there are a lot of primary rural hospitals. They’re almost constantly understaffed. It’s very hard to recruit. How do you provide critical care? Using tele-ICU is the way to do it. You can extend this to pretty much all specialties. From the perspective of the medical doctor who is an intensivist, this is absolutely a great opportunity because I can rely on the delivery of care to my patients through people like Sonia or other specialists who allow me to focus on the problems that I’m best trained to do. Tele-ICU is the perfect tool to deliver care when it’s needed and also match the needs to the skills that we represent as different healthcare providers.

Dr. Prough: One of the fascinating things to me is the interface between tele-critical care providers and the folks actually on the ground in the ICU. How do you work those interfaces?

Dr. Everhart: There’s a variety of ways that you can do that. One thing is actual cameras that are located in the patients’ rooms. All of our tele-physicians, nurses, and even myself, have a camera, and most everybody has cameras on their computers these days anyway; you can actually use a program to dial in and you come up on a screen in the patient’s room and you can have a face-to-face conversation just like we are now. Not only that way, but there’s the telephone.

When you look at the literature and talk about telehealth, telephonic communication is also a way to deliver telehealth. We have secure chat messages; if you need a quick, “Hey, this is something I need you to look at,” you can send a message that way. There’s Microsoft Teams. There are all sorts of different ways. If you think about how a lot of telehealth was provided during the COVID-19 pandemic, our iPhones with FaceTime was a huge way to provide telehealth because it was a quick and easy way to access family members and other providers and limit the number of people who were in the room taking care of that patient.

Dr. Laudanski: Not to underscore the difficulties, but you will have problems during deployment. People may be afraid, what does the tele-ICU team bring? People have a right to be anxious. But one, if you define our mission clearly, what we as a tele-ICU will do for them, it’s a great thing. This is a good foundation for future collaboration. Second thing, if you provide education, deployment of tele-ICU is not just a good camera, you need to go to the people on the ground. It’s like with everybody, you need to establish a relationship so they know you a little bit, they know they can trust you.

You also need to trust them because there’s no other way to ask them to do it except by electronic means. I cannot show up physically in the unit. Even though there are all these electronic beautiful ways to connect us, still there’s a lot of foundational work that you have to do. Otherwise you may fail in the delivery of tele-ICU. Because tele-ICU, even more than traditional ways of delivering healthcare, depends on those relationships. I need to somehow make people who I’ve never seen personally trust me, believe me, and execute my mission for the best of the patient. That sometimes means you have to spend just a little bit more time.

Dr. Everhart: Exactly. When we were starting our tele-pharmacy program at Atrium, we actually took time and went to the sites, to the hospitals that we were going to be working with, and met with the physicians and the bedside nurses and the people that we were going to be interacting with so we could develop those initial relationships that have only grown over time. That was one of the big things that we wanted to do, to make sure we had that face-to-face conversation first before we started messaging them going, Hey, I need you to do this for me.

Dr. Laudanski: This is actually one of the reasons, I think, why tele-ICU programs fail, because people believe we just deploy the technology or some workflow maybe on top of that. Then nothing works because nobody trusts each other and we don’t know how to work with each other. We did a survey some time ago as a committee, and that was one of the reasons why programs fail. The problem of tele-ICU is not just putting up cameras or using FaceTime, it’s still working the workflow, still talking to people, still getting to know each other.

Dr. Prough: Do you take advantage of personal interactions before starting the electronic connections? Do you do the same kind of thing where you meet with people personally?

Dr. Laudanski: We have a couple of approaches to get to know people and staff. First, in the deployment of the tele-ICU program, we talk to high-level management in the hospital, so we have the green light and blessing from them to go ahead with the program. Then we talk to the people on the grant—nurses, nurse supervisors, physicians, respiratory therapists. We sit with them and ask them the question, “Okay, what can we do for you that will make your work easier, better, and the interaction much more productive?”

Then we try to have a meeting with those teams every two or three months just to get to know each other. Those meetings are not with management, those meetings are with the people who sit behind the camera, with the people who work at the bedside. This is also the time when you can match what is needed with what we can deliver as a tele-ICU group, and what they need from us. Again, deployment of tele-ICU requires bidirectional collaboration, and people on the ground know very, very well what they need. We can deliver the solution, and I think this is the correct way of looking at this—we come to the people and they tell us how we can help them.

Dr. Prough: What’s the role of tele-critical care in the Society of Critical Care Medicine?

Dr. Everhart: Tele-critical care is just one way that critical care medicine is provided to a vast majority of patients across the country. We’re critical care delivery with just a different way to do it. We still have the same thought processes and everything to take care of that patient that the person at the bedside does. We just use advanced technology to help deliver that care.

Dr. Laudanski: I think the way I would look at tele-ICU in the Society of Critical Care Medicine is it’s again a different way of doing medicine but, because it’s a different and alternative way of doing medicine, it allows us to recreate our profession a little bit. How we do the things that we have been doing for the last 20 years is more or less the same way, a different way. An example: I met with a physician who told me, “During COVID, we didn’t have a chance to examine the patient as frequently because they were isolated.” It was a perfect experiment where you can look at, Were the outcomes that much different or maybe even better? I think this is what you are looking at in tele-ICU.

It’s a different paradigm, which allows you to move the profession forward; it will have to move anyway. Medicine is notoriously slow in adopting new technologies; we still use faxes and pagers in some hospitals. But tele-ICU is a new way of looking at an old problem, and this is one reason why we encounter so much, I think, misunderstanding or a little bit of shyness, I would call it, because it’s also a difficult concept. You ask somebody who carried a stethoscope to do this electronically. You send a robot, you have Sonia popping up on the screen saying, This is the way you should adjust the antibiotics. This is new technology; we have to get used to it.

Dr. Prough: SCCM has a committee, is that correct?

Dr. Everhart: Yes. SCCM has the Tele-Critical Care Committee. It is by appointment only, for a three-year term. We are currently in the process, as the Tele-Critical Care Committee, looking to explore the potential for becoming a specialty section. The advantage to that is that any level membership can join. To be part of the committee, you have to be a Professional or Select member, and you’re assigned to be on the committee, whereas if it’s a section, there’s no assignment, you just join it when you renew your membership. It can broaden our population for people to get involved and help think about how we deliver tele-critical care in the future because I know that, from when I started to where I’m at now, thanks to the COVID-19 pandemic, how I work has changed. Social media and technology are only going to continue to advance and change how we do it in the future. So we have to think about how we do this in the future, now.

Dr. Laudanski: The way I think about this transition from the committee, which has certain benefits—we’re smaller, we’re much more nimble—but we also are much more secluded. It’s like when you think about a startup. You have a startup that comes up with new ideas. Young people come on board, they have all this energy, they have all this enthusiasm, they also have the courage to break barriers. They don’t look at, What is limiting me? I don’t want to really follow the old path. How can I reinvent? They have not that much dependence on the new system. So suddenly, even within tele-ICU, there are certain groups, for lack of a better word, who believe that’s the way telemedicine should be done.

There are some people who say, No, we should maybe do it a different way. That is why you need young people, that is why you need startup mentality. When people come and say, You know what, I can do this a different way and I don’t have all this entanglement, I think that’s one of the great opportunities in the section. It’s going to probably take us some time to get there, but I think this is the way to change the dynamics around the subject. Because that change of tele-ICU will come. All of us who use the telephone for their primary care physician know very well they don’t want another appointment with the physician. The same way medicine moves forward, in several years, the normal way of practicing medicine may be gone. Then these people who reinvent the ICU must provide new ideas, enthusiasm, and innovation. That’s what we hope to achieve with this section.

Dr. Prough: I understand that there’s also a tele-critical care KEG.

Dr. Everhart: That’s correct. We have the knowledge education group, or KEG, that is part of SCCM. It is open to anyone to join, so if you are already practicing in telemedicine or want to learn more about it, it’s a great way to get involved. It’s part of SCCM Connect, all the messages roll through that platform, and you can learn more about it. That can also be a jumping-off point to get us to potentially section status or, if you’re interested, maybe signing up to be part of the committee.

Dr. Laudanski: The KEG is exactly the way to get our news out that we exist. In the KEG, you can see our announcement about the section, our research announcement. We have a whole group that works on research. We talk about education, but also, something I didn’t talk about, and the credit should absolutely go to her, is that we also have social media. The first year, this year, we opened a social, so we have our own Twitter. We started recruiting people who help us. We’re trying to get the word out and we’re looking for people to come back to us and say, This is what I want to do and commit to your section. We will use their enthusiasm.

Dr. Everhart: Absolutely. The committee has grown over the years that I’ve been involved with it. I’m going into, I think, my fifth year with the committee and just seeing how, under Krzys’s leadership, we’ve become a little more structured, which aligns with section status as well. Thinking about the number of offerings, continuing education sessions here at Congress, roundtables that we’ve participated in, Critical Connections articles that we’re working on, we need ideas, we need people to help us do all these things. The Research Committee is working on several different surveys and other research items. It’s great, but there are still things that the committee can work on, physician billing being one of those.

Dr. Laudanski: I would say everybody’s billing. How can you bill for anybody who is involved in tele-ICU? The other thing is, we have a unique opportunity to connect with the prior chairs of the Tele-ICU Committee; those people represent, at this point, all possible branches of medicine, from a hardcore physician, for lack of a better word, to any other healthcare professional, to the people who work in insurance. If we’re talking about billing, we’re talking about any problems, we actually provide a diversity of options so that if somebody comes to our committee, and hopefully the section, the sky’s the limit. It’s easy to connect people.

Dr. Prough: How are tele-critical care services paid for now in most places?

Dr. Laudanski: It’s actually a black box. The KEG did a session some time ago. We had around 20-plus people in that session, and what we discovered is a lot depends on what kind of contracts you have. Also, what is a very, very, very cloudy subject is that, before COVID, that billing didn’t exist. During COVID, we were under emergency orders, which now have disappeared, which puts pressure on the delivery of the tele-ICU services. How are we going to reinvent them? The situation is different in rural hospitals, the situation is different in academic hospitals. Some hospitals use tele-ICU as a way to augment existing services, but some hospitals utilize tele-ICU as primary billing. That is one of the very interesting ideas behind the section. We came across people who work on our committee who figure out how to bill. Suddenly we have three or five people who said, This is how we do it. There were 20 people asking, How did you do it, because we couldn’t figure it out.

One of the reasons that we have in our strategic plan right now is to create a task force, that we, as tele-ICU providers, can actually define how we would like our billing to potentially look for the future instead of waiting for CMS and other institutions to give us their opinion. They don’t work as a tele-ICU. I’m not sure what representation of tele-ICU providers there is because one thing that we discussed with Sonia is how the pharmacist can bill for services under the tele-ICU chapter; there’s no concept of it.

We, as a section or group, can actually provide that concept. What we can deliver now to our members is connection to other members of the Tele-Critical Care Committee who actually know how to bill and see if their model of billing can be reproduced in their scenario. Can that be done? Can whatever is done in other places be replicated in other places? I don’t know. That’s actually very complicated and a lot depends on the local payer mix, insurance arrangement, state regulations, even credentialing. That is why we, as a group, believe that this has to change, both in terms of providing information, incorporating nonphysicians into our billing structure, and then us telling, as a society, that that’s maybe the way we should do billing. Because we’re a unique group, our billing is very, very different and should be different than other physicians.

Dr. Prough: One intriguing thing about tele-critical care is how you can become involved even in on-site tactical procedures. It’s reasonably easy to visualize looking at data from the electronic medical record and making recommendations, but what about some bedside procedures like ultrasound?

Dr. Laudanski: Again, tele-ICU is an enhancer and an enabler. That’s the way I would put it. Many, many years ago when I started working in tele-ICU, I had providers who I would direct, by just looking at the camera, how to put in a central line. That used to be something very, very esoteric. Now it has become more and more the standard of care, I would say to a certain degree. We’re still lacking standards for that, standards that go all across but, again, it shows how many skills can be moved in the telesphere. If I have an APP or resident who feels uncomfortable doing a procedure and needs somebody just to look at the screen and walk them through the procedure, that’s where I am.

Another application during the procedure when you can use tele-ICU is just to make sure that nobody breaks sterility. We always worry about central line infection. If you put a camera in the room, you can actually observe if somebody touched something with unprotected or unshielded hands or any part of the body, which breaks sterility. Obviously, that role has to be very well vetted with the people on the ground. We do not want to have a perception that we supervise them or we’re in any form or shape punitive. But if you have a good team, that actually helps a lot. That’s what we used for COVID-19. Are you ready to do the procedure? Did you put the N95 mask on correctly? Are you gowned correctly? That’s a very simple translation to the procedure.

Next step, there’s an article in Science that there is a robot that can use actual ultrasound AI and some mechanism to put in the IV autonomously. Maybe that’s the next step of tele-ICU. I was always surprised seeing the pharmacy robots. That’s probably something normal for Sonia. But now you have, in the tele-ICU, robots that will go to patients with a stethoscope and do a lot of procedures. I think this is the next frontier. We don’t see it that much in the ICU, but robotics is probably the next thing that we’ll see that will revolutionize, to a certain degree, healthcare. Again, tele-ICU is the perfect position to utilize that technology.

Dr. Prough: A couple of times you’ve mentioned COVID. What’s been the impact of COVID on tele-critical care?

Dr. Everhart: I think it’s actually made it more accessible and, what’s the word I’m looking for, friendly. People are now more familiar with the technology. Using it to help care for patients just because we had to, we didn’t know at the beginning of the COVID pandemic, and we were trying to limit how many people were going in and out of that room. From a pharmacist’s perspective, I actually participated in virtual rounds. I would camera in to rounds and someone on the team, so they were still walking from room to room, talking about each and every patient. I couldn’t be on the unit because they didn’t want too many people there, but I could be on the unit because of the technology. I think that’s really what the pandemic did for tele-critical care, it normalized it.

Dr. Laudanski: I think it was a disruptor. Again, the medical field is sometimes resistant to change. COVID-19 gave us no choice but to adapt, and it put incredible pressure on a lot of healthcare systems; they had to transform one way or the other. One of the transformation forces was telemedicine. Then people discovered that actually telemedicine, one, can save lives, but it can also make their work safer and more effective. All of this led to anxiety and novelty from using telemedicine, and I think that was a great change that happened. What is happening after COVID, unfortunately, is we see some of these changes being crawled back, mostly because of reimbursement. Again, you remove the pressure, the system starts evolving sometimes a little bit backwards.

But I think the impression is still there. A lot of hospital systems now at least are asking, How can I deploy tele-ICU? They may not know how to do it, but at least they’ve started asking the question. Before, we as tele-ICU ambassadors, for lack of a better word, would go to the system and say, Hey, why don’t you think about tele-ICU? Now, the hospital says, Should we deploy tele-ICU? Quite often, this discussion goes nowhere because the system may not be ready, there are no reimbursement plans, and other barriers are in place. But at least they started asking the question. I think that’s what COVID did to a very, very large degree. People start thinking differently and people see tele-ICU not as a threat but as an ally. Now there’s something that can remove me from danger. Now there’s something that can deliver more care with more efficiency.

Dr. Prough: If I understand correctly, both of you work in large urban centers that provide tele-critical care to smaller surrounding rural hospitals.

Dr. Laudanski: Yes.

Dr. Everhart: Yes.

Dr. Prough: Is it also possible to have tele-critical care within a big hospital?

Dr. Laudanski: I think you can have both. This is the beauty of tele-ICU. When you think about tele-ICU, the first question is, What problem do I try to address? When there was COVID-19, we faced an acute shortage of respiratory therapists, and developing the eRT or the visual therapies was the need that we had to address. Tele-ICU was the perfect means for that. We had a system in place and that’s how we addressed that need. Then COVID was over, and our demands and supply on the RT services stabilized. The next question was, What do you do? And the next evolution step was to develop a high-reliability medical system, and tele-ICU is the way to deliver a high quality of care and minimize risk. So we went back to the do-no-harm basics using telemedicine. Part of the team that we incorporated was an APP, and now, we’re thinking, Okay, how can the pharmacist contribute?

Because if I have a Sonia who will look at my chart and say, This patient may be too sedated, you can tweak the orders and she will have that conversation in parallel with me. That means that our patients have less delirium, our patients leave the hospital faster. But is that a problem of the given hospital? That goes to the question, What’s needed in rural hospitals? What’s needed in academic centers? Each academic center is different. I’m sure that we can have a discussion with Sonia about North Carolina and Minnesota but, again, tele-ICU is not a blank big umbrella; it’s actually a very, very specialized tool. I think she works in a much more heterogeneous system than I do, and I’m pretty sure what she has to deliver to Hospital A is different than Hospital B, but probably you should talk about this, Sonia.

Dr. Everhart: We actually do have some form of tele-critical care available in our large academic medical centers. Not our largest ones, but the second-largest facility that I work in, we actually have cameras available for ICU patients who may be boarding in the emergency department. Those are deployed into the smaller facilities as well, so that if you have that critical patient who is awaiting transfer, you have that intensivist on the other side of the camera who can help manage that patient so the ED physician is freed up to go do a trauma or whatever else. So there’s a multitude of different ways that tele-critical care can be deployed in large academic medical centers. Think about long-term acute care hospitals. They have patients who crash there all the time. Do they always need to be transferred back to that large academic medical center? Could you be part of putting a camera in a room or two at an LTAC? Things like that are other ways that tele-critical care can be beneficial.

Dr. Prough: Help me a little bit with understanding how the shortage of respiratory therapists was dealt with during COVID. I tend to think of respiratory care as something that’s done at the bedside. How do you make remote respiratory care work?

Dr. Laudanski: The interesting thing is that, when you think about everybody’s care, there is a part of the task that we do every single day. There’s some kind of routine. RT, pharmacists, doctors have to go through the chart, have to check certain things. You think about our workflow, there are routine tasks, there are urgent tasks, and there are tasks that have to be done right now. In terms of RT, when we looked at their scope of practice, we thought, Well, you have to, for example, go to the ventilator every one hour, every two hours, and check the settings. In the realm of COVID-19, you have to go to the room and get exposed to that environment. So why not do that check through remote means? That is one way we use eRT, we can camera in the room, look at the ventilator, write up all the numbers, look at the trends. That’s a very, very, I would say, laborious process, but it’s a process that has to be done anyway. Each hospital needs to have documentation. Documentation has to be aligned with what happened to the patient. This is one way we utilize eRT.

The second thing is, What if the patient is crashing or the patient needs adjustment? The nurse can just push the button, get us in the room. We can look at the ventilator and actively, quickly determine whether this patient needs adjustment in flow, maybe this patient needs a change of modes. At least at that time, we can troubleshoot it, so by the time the respiratory therapist, a physical person, gets in, we’ve already worked through that list of problems. But it also means that if you have some kind of technical malfunctioning, you can probably fix it with the help of the nurse. You don’t need that RT to actually walk two floors from somewhere to fix it. It helps balancing the load one way or the other.

The third thing is, you have both an RT and an MD who can troubleshoot patients who are profoundly hypoxemic or very, very complex. If you think about COVID, when we had a shortage of RTs, nurses, and MDs, having that expertise available to you practically on a minute’s notice, first of all, it’s rushed, right? The second thing is, it’s, again, providing a bunch of people coming together and coming up with the best solution for the patients. That’s the way we look at the eRT service. In the first step, we focus quite a lot on those different routine tasks. Then in the next transformation, what we plan to do is minimize routine tasks and figure out when we help patients precisely, how many accidental extubations we can avoid, how we can shorten the time between surgery and extubation for patients. Again, RT can do those assessments remotely.

I think, for me, the difficult part of the task was, I see a lot of things that we have to do physically, but if you ask yourself how much you have to be in the room and you carefully examine that, it’s not that much. I don’t know that Sonia has to be in the room at all, so that’s a relatively easy task to think about. But then you ask, Well, do you need to have a doctor, do you have to have an RT? I’m sure there are certain tasks that the nurses have to do. But for the APP, RN, and MD, maybe you should ask, How often do you have to be in the room? Because it takes time to be in the room. It exposes patients to the risk of cross-infections and exposes us to the danger of, for example, having patients with COVID, which I can also get as a doctor.

Dr. Prough: This has been very interesting. Are there any final thoughts that either of you would like to provide for our listeners?

Dr. Everhart: My final thought is, if you’re thinking about tele-critical care and providing that service, reach out to the KEG, reach out to the Tele-Critical Care Committee. We’re happy to help and answer your questions as best we can.

Dr. Laudanski: I’m a total believer in tele-ICU. If there’s anybody out there who feels that they want to change medicine, we are the group to join.

Dr. Prough: Thank you very much. This concludes another edition of the Society of Critical Care Medicine Podcast. For the Society of Critical Care Medicine Podcast, I’m Don Prough.

This podcast is sponsored by Equum Medical and CLEW Medical. Tele-ICU technology is revolutionizing critical care delivery, allowing healthcare professionals to remotely monitor and treat critically ill patients in real time. As a nationally recognized acute care clinical services company, Equum brings the people and processes to power hospital telehealth programs, optimizing patient flow and clinical access. CLEW’s AI-powered platform enhances critical care decision-making with FDA-cleared predictive insights and workflow accelerators. Equum and CLEW unite the people, processes, and technology to transform the high-acuity and critical care experience. Learn more about these companies at equummedical.com and clewmed.com.

Donald S. Prough, MD, FCCM, serves as the SCCM Podcast editor. He is the Rebecca Terry White Distinguished Professor and chair of anesthesiology at the University of Texas Medical Branch in Galveston, Texas, USA. Dr. Prough completed his undergraduate studies at Lafayette College Medical School at Penn State University College of Medicine, residency at the National Naval Medical Center, fellowship training in critical care at the National Naval Medical Center, and cardiac anesthesiology at University of Alabama Birmingham. He has served on SCCM’s Council and is a scientific editor of Critical Care Medicine.

This podcast was recorded during the Society of Critical Care Medicine’s 2023 Critical Care Congress. Access essential education online through Congress Digital. More than 120 sessions are available on an easy-to-use platform. Continuing education credit is also available. Some SCCM members receive complimentary access to Congress Digital. To learn more, visit sccm.org/congressdigital.

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