In response to the COVID-19 pandemic, the Telemedicine & Advanced Technology Research Center (TATRC), part of the US Army Medical Research and Development Command, developed the National Emergency Tele-Critical Care Network (NETCCN). The aim of NETCCN is to bridge the gap in availability and capacity of critical care expertise, specifically in areas that lack intensive care units (ICU). This network facilitates tele-critical care (TCC), allowing clinicians in resource-limited locations to access a network of expert clinicians and critical care guidance.
TCC is often based on a hub and spoke model, starting from a central location with pre-established relationships and collaborations. However, in the event of a pandemic or disaster when these “hubs” are overwhelmed, this model becomes ineffective. Furthermore, non-traditional sites of care, such as field hospitals or convention centers, are typically outside of the TCC network. NETCCN addresses these obstacles by offering a secure, smartphone-based “anywhere to anywhere” telehealth network that connects frontline clinicians with the required resources and support.
NETCCN was deployed with a group of nine clinical-technical teams in June 2020, less than three months after the beginning of the pandemic. By September, NETCCN began its first mission in supporting a COVID-19 surge at a civilian hospital in Guam. The network has since supported over 60 hospitals in 19 states and territories, assisting over 1,000 unique patients. Despite providing support at no cost, the widespread deployment of NETCCN has faced challenges relating to licensure, credentialing, and the concept of an “anywhere to anywhere” service.
In the future, the intention is to incorporate NETCCN into public health and disaster response efforts, as well as modern warfare scenarios, where large numbers of casualties and delayed ability to evacuate soldiers are potential issues. This shift to telehealth models is part of a broader reconsideration of traditional care models, in light of healthcare system strains, disasters, and potentially changing nature of warfare. In these contexts, it is increasingly important to adapt care models, policies, workflows, and reimbursement strategies to optimally support frontline caregivers and their patients.
