Remote critical care consultation: telehealth projection of clinical specialty expertise.

Remote critical care consultations have been employed between the Naval Hospital in Guam and the Tripler Army Medical Center in Hawaii, a distance of 5300 km. During a 10-week study period there were physician-physician daily consultation rounds for patients in the intensive care unit at the Naval Hospital. Physiological data, video-images and sound were transmitted via a 768 kbit/s frame relay connection, albeit with a 1-3 s delay. During the study there were 87 consultations concerning 25 patients. Preliminary results showed that a broad range of critical care patients could be managed effectively through daily remote critical care consultation. Broader implementation of this strategy may represent a method of making critical care expertise available to front-line military health-care facilities and to remote civilian facilities with limited critical care expertise.