TY - JOUR
T1 - Peer-to-peer tele-consultative services for critical care, Afghanistan, Kenya, Pakistan, United Republic of Tanzania
AU - Latif, Asad
AU - Atiq, Huba
AU - Zaki, Mareeha
AU - Hussain, Syeda A.
AU - Ghayas, Ammarah
AU - Shafiq, Omer
AU - Daudpota, Ali A.
AU - Abbas, Qalab
AU - Ariff, Shabina
AU - Asghar, Muhammad A.
AU - Khan, Muhammad F.
AU - Khan, Muhammad H.
AU - Rashid, Naveed
AU - Sabeen, Amber
AU - Sohaib, Muhammad
AU - Ullah, Hameed
AU - Munir, Tahir
AU - Hassan, Mohammad M.
AU - Sami, Kiran
AU - Amin, Syed K.
AU - Samad, Zainab
AU - Haider, Adil
N1 - Publisher Copyright:
© 2025 The authors; licensee World Health Organization.
PY - 2025
Y1 - 2025
N2 - Objective To develop a tele-intensive care service providing peer-to-peer teleconsultation for physicians in remote and resource-constrained health-care settings for treatment of critically ill patients, and to evaluate the outcomes of the service. Methods The Aga Khan University started the coronavirus disease 2019 (COVID-19) tele-intensive care unit in 2020. A central command centre used two-way audiovisual technology to connect experienced intensive care specialists to clinical teams in remote hospital settings. The service, always available, used messaging applications and telephone calls. Coverage was later extended to other medical, neonatal, paediatric and surgical patients requiring critical care. Findings Between June 2020 and December 2023, the service provided 6014 teleconsultations to manage 1907 patients in 109 medical facilities, mostly in Pakistan and also Afghanistan, Kenya and United Republic of Tanzania. Of the 1907 patients, 652 (34.4%) had COVID-19 and 1244 (65.6%) had other illnesses. The mean duration of teleconsultations was 14.5 min. Of 581 patients for whom outcome data were available, 204 (35.1%) died. Multivariate multinomial logistic regression showed the odds of death decreased with increased number of consultations (> 3) per patient (adjusted odds ratio (aOR): 0.28; 95% confidence interval, CI: 0.16–0.48), and increased number of recommendations (≥ 5) per consultation (aOR: 3.09; 95% CI: 1.08–8.84). Conclusion Our tele-intensive care service helped manage critically ill patients in regions where intensive care had not previously been available. While research on the clinical impact of this model is needed, decision-makers should consider its use to increase provision of critical care in remote and resource-constrained health-care settings.
AB - Objective To develop a tele-intensive care service providing peer-to-peer teleconsultation for physicians in remote and resource-constrained health-care settings for treatment of critically ill patients, and to evaluate the outcomes of the service. Methods The Aga Khan University started the coronavirus disease 2019 (COVID-19) tele-intensive care unit in 2020. A central command centre used two-way audiovisual technology to connect experienced intensive care specialists to clinical teams in remote hospital settings. The service, always available, used messaging applications and telephone calls. Coverage was later extended to other medical, neonatal, paediatric and surgical patients requiring critical care. Findings Between June 2020 and December 2023, the service provided 6014 teleconsultations to manage 1907 patients in 109 medical facilities, mostly in Pakistan and also Afghanistan, Kenya and United Republic of Tanzania. Of the 1907 patients, 652 (34.4%) had COVID-19 and 1244 (65.6%) had other illnesses. The mean duration of teleconsultations was 14.5 min. Of 581 patients for whom outcome data were available, 204 (35.1%) died. Multivariate multinomial logistic regression showed the odds of death decreased with increased number of consultations (> 3) per patient (adjusted odds ratio (aOR): 0.28; 95% confidence interval, CI: 0.16–0.48), and increased number of recommendations (≥ 5) per consultation (aOR: 3.09; 95% CI: 1.08–8.84). Conclusion Our tele-intensive care service helped manage critically ill patients in regions where intensive care had not previously been available. While research on the clinical impact of this model is needed, decision-makers should consider its use to increase provision of critical care in remote and resource-constrained health-care settings.
UR - http://www.scopus.com/inward/record.url?scp=85217357718&partnerID=8YFLogxK
U2 - 10.2471/BLT.23.290926
DO - 10.2471/BLT.23.290926
M3 - Article
C2 - 39882490
AN - SCOPUS:85217357718
SN - 0042-9686
VL - 103
SP - 90
EP - 98
JO - Bulletin of the World Health Organization
JF - Bulletin of the World Health Organization
IS - 2
ER -