TY - JOUR
T1 - The impact of telehealth in sepsis care
T2 - A systematic review
AU - Tu, Kevin J.
AU - Wymore, Cole
AU - Tchangalova, Nedelina
AU - Fuller, Brian M.
AU - Mohr, Nicholas M.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: KJT was supported by a Daniel and Carly Rochkind research grant and a Banneker/Key scholarship, both provided by the University of Maryland Honor College. NMM was supported by a grant from the Agency for Healthcare Research and Quality (AHRQ, grant K08HS025753) and the Health Resources and Services Administration (HRSA, award U3GRH40003). The views expressed in this publication are solely those of the authors and do not reflect the official views of the funders or the U.S government.
Publisher Copyright:
© The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - Objectives: Sepsis is associated with significant mortality. Telehealth may improve the quality of early sepsis care, but the use and impact of telehealth applications for sepsis remain unclear. We aim to describe the telehealth interventions that have been used to facilitate sepsis care, and to summarize the reported effect of telehealth on sepsis outcomes. Data Sources: We identified articles reporting telehealth use for sepsis using an English-language search of PubMed, CINAHL Plus (EBSCO), Academic Search Ultimate (EBSCO), APA PsycINFO (EBSCO), Public Health (ProQuest), and Web of Science databases with no restrictions on publication date. Study Selection: Included studies described the use of telehealth as an intervention for treating sepsis. Only comparative effectiveness analyses were included. Data Extraction and Synthesis: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, two investigators independently selected articles for inclusion and abstracted data. A random-effects subgroup analysis was conducted on patient survival treated with and without telehealth. Results: A total of 15 studies were included, involving 188,418 patients with sepsis. Thirteen studies used observational study designs, and the most common telehealth applications were provider-to-provider telehealth consultation and intensive care unit telehealth. Clinical and methodological heterogeneity was significantly high. Telehealth use was associated with higher survival, especially in settings with low control group survival. The effect of telehealth on other care processes and outcomes were more varied and likely dependent on hospital-level factors. Conclusions: Telehealth has been used in diverse applications for sepsis care, and it may improve patient outcomes in certain contexts. Additional interventional trials and cost-based analyses would clarify the causal role of telehealth in improving sepsis outcomes.
AB - Objectives: Sepsis is associated with significant mortality. Telehealth may improve the quality of early sepsis care, but the use and impact of telehealth applications for sepsis remain unclear. We aim to describe the telehealth interventions that have been used to facilitate sepsis care, and to summarize the reported effect of telehealth on sepsis outcomes. Data Sources: We identified articles reporting telehealth use for sepsis using an English-language search of PubMed, CINAHL Plus (EBSCO), Academic Search Ultimate (EBSCO), APA PsycINFO (EBSCO), Public Health (ProQuest), and Web of Science databases with no restrictions on publication date. Study Selection: Included studies described the use of telehealth as an intervention for treating sepsis. Only comparative effectiveness analyses were included. Data Extraction and Synthesis: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, two investigators independently selected articles for inclusion and abstracted data. A random-effects subgroup analysis was conducted on patient survival treated with and without telehealth. Results: A total of 15 studies were included, involving 188,418 patients with sepsis. Thirteen studies used observational study designs, and the most common telehealth applications were provider-to-provider telehealth consultation and intensive care unit telehealth. Clinical and methodological heterogeneity was significantly high. Telehealth use was associated with higher survival, especially in settings with low control group survival. The effect of telehealth on other care processes and outcomes were more varied and likely dependent on hospital-level factors. Conclusions: Telehealth has been used in diverse applications for sepsis care, and it may improve patient outcomes in certain contexts. Additional interventional trials and cost-based analyses would clarify the causal role of telehealth in improving sepsis outcomes.
KW - Sepsis
KW - patient outcomes
KW - processes of care
KW - survival
KW - systematic review
KW - tele-ICU/tele-ED
KW - telehealth
UR - http://www.scopus.com/inward/record.url?scp=85153765502&partnerID=8YFLogxK
U2 - 10.1177/1357633X231170038
DO - 10.1177/1357633X231170038
M3 - Article
C2 - 37093782
AN - SCOPUS:85153765502
SN - 1357-633X
JO - Journal of Telemedicine and Telecare
JF - Journal of Telemedicine and Telecare
ER -