To Infinity and Beyond: The Past, Present, and Future of Tele-Anesthesia

Kathryn Harter Bridges, MD; Julie Ryan McSwain, MD; Phillip Ryan Wilson, MD

Disclosures

Anesthesiology. 2020;132(2):276-284. 

In This Article

Abstract and Introduction

Abstract

Because the scope of anesthesia practice continues to expand, especially within the perioperative domain, our specialty must continually examine technological services that allow us to provide care in innovative ways. Telemedicine has facilitated the remote provision of medical services across many different specialties, but it remains somewhat unclear whether the use of telemedicine would fit within the practice of anesthesiology on a consistent basis. There have been several reports on the successful use of telemedicine within the preoperative and intraoperative realm. However, patient selection, patient and provider satisfaction, case cancellation rates, equipment reliability, and security of protected health information are just some of the issues that require further examination. This article seeks to review comprehensively the available literature related to the use of telemedicine within the preoperative, intraoperative, and postoperative phases of anesthetic care as well as analyze the major hurdles often encountered when implementing a teleconsultation service. Security of connection, data storage and encryption, federal and state medical licensure compliance, as well as overall cost/savings analysis are a few of the issues that warrant further exploration and research. As telemedicine programs develop within the perioperative arena, it is imperative for institutions to share knowledge, successes, and pitfalls to improve the delivery of care in today's technology-driven medical landscape.

Introduction

Telemedicine, a term originally created in the 1970s, literally means "healing at a distance."[1,2] The World Health Organization now defines telemedicine as the provision of health care services via the use of communication technology for the diagnosis and treatment of diseases and for continuing education of health care providers in settings where distance is a factor.[3] Over the past decade, the use of telemedicine for patient evaluation and treatment has grown. Initially used primarily for radiological and emergency medicine services, the use of telemedicine technology has expanded to include nearly every field of medicine, from subspecialty services to primary care. Anesthesiology has embraced the use of telemedicine both as a means to perform preoperative evaluations and to provide remote intraoperative patient monitoring in a care team model. Models for postoperative care in both home and intensive care unit (ICU) settings have also evolved to include virtual care capabilities. Telemedicine presents a unique opportunity to expand the reach of anesthesiologists to patients throughout the perioperative period and marks a source of potential growth and expansion within the specialty.

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