More than 25 years have passed since the original description of intensive care unit (ICU) telemedicine, a technological strategy to improve critical care outcomes by expanding the reach and availability of intensivist clinicians.1 Since then, the understanding of evidence-based practice and the role of information technology in the ICU have substantially increased. Multiple commercial applications of ICU telemedicine now exist, and telemedicine is widely touted as an all-encompassing strategy to improve ICU outcomes.2 Yet even after 25 years, the optimal role of telemedicine in the ICU remains uncertain.3 A large, multicenter study published recently showed no demonstrable clinical benefit,4 and a recent meta-analysis found no beneficial association between ICU telemedicine and in-hospital mortality.5 These results have left clinicians, hospital administrators, and policy makers wondering how to best use this technology, if at all.
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