Control Tower in the hospital: a structure–process–outcome systemic review of telemedicine systems for interprofessional collaboration

Category	Detail
Condition	Acute critical illness and complex chronic conditions (e.g., sepsis, acute kidney injury, stroke)
Key Mechanisms	Telemedicine-enabled remote patient monitoring and interprofessional communication to support timely recognition and intervention
Target Population	Hospitalized patients at risk of physiological deterioration, large cerebral vessel occlusion, acute kidney injury, and other critical conditions
Care Setting	In-hospital settings involving bedside staff and off-site specialist teams

Telemedicine interventions improve in-hospital care processes such as timeliness, treatment appropriateness, and diagnostic accuracy.
Meta-analysis shows telemedicine reduces hospital length of stay by approximately 1 day but may increase readmission rates.
Effectiveness of telemedicine varies by patient condition, application setting, interprofessional collaboration model, and workflow.

Use telemedicine to enhance early recognition of patient deterioration through remote monitoring and specialist input.
Incorporate telemedicine to improve diagnostic accuracy in acute conditions like stroke and acute kidney injury.

Implement telemedicine-supported interprofessional collaboration models to facilitate timely and appropriate interventions.
Adopt telemedicine systems that enable real-time communication between bedside staff and off-site specialists, especially in urgent scenarios.

Utilize telemedicine for continuous remote patient monitoring to detect physiological deterioration early.
Apply automated notifications to trigger interprofessional team activation when indicated.

Be aware of potential increased hospital readmission rates associated with telemedicine interventions.
Consider variability in effectiveness depending on patient condition and care setting when implementing telemedicine.

Hospitalized patients with acute critical illness or complex chronic conditions requiring interprofessional care

Telemedicine interventions improve care processes and reduce length of stay but may increase readmissions; tailored application is necessary.

Select telemedicine models based on clinical context: Model 1 for comprehensive remote monitoring and communication; Model 2 for urgent real-time specialist involvement; Model 3 for bedside-initiated specialist activation.
Engage multidisciplinary teams including infarct teams, rapid response teams, nephrology, infectious disease, pharmacology, anesthesiology, and tele-sepsis specialists as appropriate.
Ensure workflows incorporate automated alerts and clear communication pathways to optimize timely interventions.

Clinical Scorecard: Telemedicine Systems for Interprofessional Collaboration in Hospitals: A Systematic Review of Structure, Process, and Outcomes