Two months after leaving the intensive care unit, Rob Rainer returned to his law practice in Revere, eager to resume his old life after surviving a severe lung infection that tethered him to a breathing machine for a month.
But as he sat down at his desk, the former hard-driving multitasker found he couldn’t stay on track with even one task. Phone conversations left him overwhelmed. He was baffled by a computer program he himself had developed.
Today, five years later, Rainer’s life is very different — his law practice shuttered, his two houses sold. At 58, he lives modestly with his wife in a small condo in Hudson, N.H.
While the novel coronavirus didn’t exist in 2015, today thousands of COVID-19 patients in the United States are enduring the same experience that Rainer did, lying in a medication-induced coma as a ventilator pushes air into their weakened lungs for days or weeks on end. And like Rainer, many will never be the same.

Pain, Agitation, and Delirium Management Orderset

For post-ICU recovery clinics, the opportunities that exist for telehealth and mobile
technologies to help extend care delivery, reduce costs, improve the quality of care, and the patient experience in the post discharge period are significant. The demand for intensive care is projected to rise because of an aging population with complex comorbidities and the expanded use of advanced healthcare treatments, and as a result, the number of ICU survivors will rise . Survivors of critical illness require early identification of symptoms and early interventions to decrease symptom burden and enhance their quality of life. Redesign of post-ICU care management and post acute care delivery systems is needed to engage ICU survivors in self-care, monitor for early signs of deteriorating health, intervene early, and reduce costs. As new value-based payment models for medical services increasingly take hold, financial incentives will also need to align with rehabilitation-oriented services in this population with greater focus on post-ICU care.