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Objective measures to assess performance and quantify success e.g. clinical and economic outcome parameters are desirable but not easily accessible in international collaboration with very diverse clinical settings and legal prerequisites. Therefore, we initiated a study to evaluate the performance in our tele-intensive care unit network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an online survey addressing clinical staff at ten spoke sites in four countries connected to one TICU hub to assess subjective clinical benefit, acceptance and potential for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of the 30 participants felt well supported clinically and personally, with a high acceptance and trust as well as a positive working relationship in tele-medical collaboration. Ethical principles and data protection were discovered to be persistently of utmost significance in tele-intensive care unit networks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>International telemedicine in critical care is perceived positively without major differences between diverse health care systems when crossing borders, showing potential for improvement to guide future clinical and research approaches.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Clinical trial registiry:<\/jats:italic>\n                      The study was registered on August 11th, 2023 with the German Clinical Trials Register (DRKS-IDDRKS00032246;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.drks.de\/search\/de\/trial\/DRKS00032246\/details\" ext-link-type=\"uri\">https:\/\/www.drks.de\/search\/de\/trial\/DRKS00032246\/details<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13104-026-07884-6","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T21:03:47Z","timestamp":1779483827000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Survey to evaluate clinical benefits and acceptance in international tele-intensive care unit collaboration"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1346-9325","authenticated-orcid":false,"given":"Franziska","family":"Lezius","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Steinecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Herholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Sch\u00fc\u00fcrhuis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vadym","family":"Terentyuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Lisnyy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khkmat","family":"Anvarov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fathima","family":"Paruk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens-Peter","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Grosse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Edel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hechler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia D.","family":"Spies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"issue":"7","key":"7884_CR1","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1177\/0885066617726942","volume":"33","author":"J Chen","year":"2018","unstructured":"Chen J, Sun D, Yang W, Liu M, Zhang S, Peng J, et al. 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As specified in the ethics proposal and explicitly approved by the Institutional Review Board of Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin the ethics approval includes all participating facilities within the international TICU network consenting to data collection, therefore ethics approval was not obtained separately in the other participating countries. Informed consent to participate was obtained from all of the participants in this study prior to participation. Participation was anonymous, no personal information was acquired. The study was conducted in compliance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Conflicts of interest: Claudia Spies received support for the present manuscript from BMBF \/ RKI i.e. TICO-COVID-19; FUTURE-MOCCA; FUTURE UGA; FUTURE UZB; FUTURE ZAF; FUTURE UKR, FUTURE WASP (2020 \u2013 2025), grants or contracts from Deutsche Forschungsgemeinschaft \/ German Research Society, Deutsches Zentrum f\u00fcr Luft- und Raumfahrt e. V. (DLR) \/German Aerospace Center, Einstein Stiftung Berlin\/ Einstein Foundation Berlin, Gemeinsamer Bundesausschuss \/ Federal Joint Committee (G-BA), Inneruniversit\u00e4re Forschungsf\u00f6rderung \/ Inner University Grants, Projekttr\u00e4ger im DLR \/ Project Management Agency, Stifterverband\/ Non-Profit Society Promoting Science and Education, European Society of Anaesthesiology and Intensive Care (public\/reviewed grant), BMWI - Federal Ministry for Economic Affairs and Climate Action (ZIM, KF2027803KJ2), Georg Thieme Verlag (Payment for book contribution as author), Dr. F. K\u00f6hler Chemie GmbH (IIT; CESARO Study, Phydelio Study, LoveMi Study), Sintetica GmbH (IIT: PODSPA Study), Gemeinsamer Bundesausschuss \/ Federal Joint Committee (G-BA) -Innovationsfond (2017 \u2013 2020 ERIC (01NVF16011)), Gemeinsamer Bundesausschuss \/ Federal Joint Committee (G-BA) -Innovationsfond (2019-2025 PR\u00c4P-GO (01NVF18024)), Max-Planck-Gesellschaft zur F\u00f6rderung der Wissenschaften e.V. (ERONA 2019-2021), Stifterverband f\u00fcr die deutsche Wissenschaft e.V. \/ Metronic (E-Health shared decision allocation (2018-2024)), Philips ElectronicsNederland BV (2019 - 2023: ICU Feel Better App), BMBF - Federal Ministry of Education and Research (2020: CEO-sys ; EViPan Unimed; CODEX+; Prepared), Deutsche Forschungsgemeinschaft \/ German Research Society (2020-2026: \u201cHeisenberg professorship\u201d), Gemeinsamer Bundesausschuss \/ Federal Joint Committee (G-BA) -Innovationsfond (2020-2023 SEPWISS), BMBF (2021-2022 STAIRS; STAIRS RHISSA 2023-2028), Gemeinsamer Bundesausschuss \/ Federal Joint Committee (G-BA) \u2013Innovationsfond (2022-2024 iWILL, 2022-2024 E=MC\u00b2 (01VSF21035), 2023-2025 DigiPOD (01VSF22040)), The European Commission Horizont Europa (2024-2028 EPIC (101137221)), holds patents (planned\/issued\/pending) Issued EUROPE (GER; AT; CH; LI; DE; FR; GB; NL) Inventor (15753 627.7), Issued US Patent; Inventor (PCT\/EP 2015\/067731), Issued EUROPE (GER; CH; LI; DE; FR; NL) Inventor (3 174 588), International Patent Germany (10 2014 215 211.9, 10 2018 114 364.8, 10 2018 110 275.5, 50 2015 010 534.8, 50 2015 010 347.7, 10 2014 215 212.7), participated on a Data Safety Monitoring Board or Advisory Board for Prothor (2023), Takeda Pharmaceutical Company Limited (2024), Lynx Health Science GmbH (2024), holds a leadership or fiduciary role in other board, society, committee or advocacy group (unpaid) at AWMF (Association of the Scientific Medical Societies in Germany), Deutsche Forschungsgemeinschaft (German Research Foundation) review boards, Deutsche Akademie der Naturforscher Leopoldina e. V. \u2013 German National Academy of Sciences \u2013 Leopoldina, Berliner Medizinische Gesellschaft, ESICM - European Society of Intensive Care Medicine, ESAIC - European Society of Anaesthesiology and Intensive Care, Deutsche Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin - German Society of Anaesthesiology and Intensive Care Medicine (DGAI), Deutsche Interdisziplin\u00e4re Vereinigung f\u00fcr Intensiv- und Notfallmedizin - German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), Deutsche Sepsis-Stiftung \u2013 German Sepsis Foundation. Bj\u00f6rn Wei\u00df received grants or contracts from Future-UKR, German Ministry of Health, Innovation Funds 01VSF21035 (2022), payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sedana Medical, institutional (2024), Dr. F. Koehler Chemie, institutional and personal (2025), Teladoc Health GmbH (2025), support for attending meetings and\/or travel from Teladoc Health GmbH, holds a leadership or fiduciary role in other board, society, committee or advocacy group (unpaid) as DGAI State Chair Berlin. Andreas Edel received payment or honoraria for lectures, presentations, speakers bureaus, manuscript from Dr\u00e4ger Medical Deutschland GmbH and is a member of the German Society for Anesthesiology and Intensive Care Medicine (DGAI), DGAI Round Table Tele-ICU.Franziska Lezius, Karin Steinecke, Stephen Sch\u00fc\u00fcrhuis, Anne Herholz, Vadym Terentyuk, Ivan Lisnyy, Khkmat Anvarov, Fathima Paruk, Jens-Peter K\u00f6nig, Joachim Grosse and Daniel Hechler declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"237"}}