814: Telemedicine-Enabled Icu Recovery Clinics: Implementation Outcomes of the Teleport Pilot Study

Introduction: Critical illness survivors often develop post-intensive care syndrome (PICS) that can limit their capacity to participate effectively in recovery care. Telemedicine-enabled ICU Recovery Clinics (ICU-RC) may improve accessibility, but their implementation has not been well studied. We evaluated the feasibility, acceptability, appropriateness, and fidelity of a telemedicine ICU-RC intervention. Methods: We report results of a pilot feasibility randomized controlled trial of a telemedicine ICU-RC which included 91 patients with septic shock or acute respiratory distress syndrome randomly assigned 1:1 to intervention (N = 46 with scheduled multidisciplinary telemedicine ICU-RC visits at 3- and 12-weeks post-discharge) or control (N = 45 treatment-as usual). Within the intervention group, feasibility was assessed by validated measures (12-item, 5-point Likert scale 1 strongly disagree - 5 strongly agree) and fidelity was assessed using real-time monitoring of visits. Data were analyzed with descriptive statistics. Results: Participants were middle-aged (median = 56), White (91%), and male (51%). In the telemedicine group, 23 (50%) attended at least one ICU-RC visit; with 60% and 49% at 3- and 12-weeks, respectively. Attrition reflects 5 withdrawals, 1 deceased, and 3 lost to follow up. Median visit durations were 52 minutes at 3-weeks and 34 minutes at 12-weeks. Participants rated telemedicine ICU-RC as feasible (median = 4.38), acceptable (median = 4.13), and appropriate (median = 4.13) for PICS care. We achieved high multidisciplinary fidelity at both 3- and 12-weeks, ranging 73-100% participation of pharmacist, physician, nurse practitioner, and psychologist. The most common visit activities were medication reconciliation (100%), review of immunization status (85%), evaluation of psychological needs (85%), debrief of ICU course and expected recovery (79%), and discussion of smoking (72%). Conclusions: The telemedicine ICU-RC demonstrated strong implementation outcomes. Although patient ratings of feasibility, acceptability, and appropriateness were favorable, high attrition limits the generalizability of these patient-reported outcomes. These findings suggest telemedicine is a promising strategy to improve access to PICS care and warrant further study in larger, more diverse populations.