Intraoperative Telemedicine Program: ACTFAST-3 Study

By Danélia Botes

September 28, 2023

Introduction to the ACTFAST-3 Study

The Anesthesiology Control Tower (ACT), a real-time telemedicine decision support system, was tested in the ACTFAST-3 Randomised Clinical Trial. The study aimed to evaluate the feasibility of the ACT and its impact on two quality of care measures: postoperative hypothermia and hyperglycemia.

The ACTFAST-3 study, a single-centre pilot superiority RCT, took place in the USA from April 2017 to June 2019. The study involved all patients aged 18 years and above who had undergone surgery. However, the study did not include patients if the ACT staff did not staff more than 50% of their case duration or if they did not suffer from diabetes (for glycemic outcomes).

Results and Implications

The pilot study, involving 26,254 patients, found that the telemedicine decision support intervention did not significantly alter the two quality of care outcomes. While there was a slight increase in intraoperative glucose measurement in the intervention group, there was no difference in the frequency of treatment for hyperglycemia. This lack of difference could explain the unchanged postoperative hyperglycemia rates.

The study also highlighted potential reasons for these results. For instance, the high adherence to each measure at baseline made significant improvements challenging. Also, the trial noted the impact of the Hawthorne effect, where changes in behaviour occur due to the awareness of being observed.

The study concluded that further optimization of clinical decision support and workflows might help the intraoperative telemedicine program achieve improvement in targeted clinical measures.


The ACTFAST-3 study offers crucial insights into the application of telemedicine in anesthesiology, yet it underscores the complexity of enhancing care quality through such interventions. Despite the implementation of the Anesthesiology Control Tower, improvements in postoperative hypothermia and hyperglycemia were not evident. This outcome suggests that high baseline adherence to quality measures and behavioural modifications due to the Hawthorne effect may dilute the impact of telemedicine interventions. Consequently, to realise the potential benefits of real-time decision support systems, we must refine clinical support tools and streamline operative workflows. The findings prompt a re-evaluation of strategies within the telemedicine framework to ensure that technological advancements translate into tangible improvements in patient care. 

Reference url

Recent Posts

Cutaneous Malignant Melanoma Treatment

Forecasting Innovations in Cutaneous Malignant Melanoma Treatment in Sweden

“Shaping Melanoma Care: Insights for UV Safety Month”

🌟 Exciting Insights! Learn how system dynamics modelling shapes the future of cutaneous malignant melanoma care during UV Safety Month. Discover key strategies for better healthcare planning and patient outcomes. #SyenzaNews #UVSafetyMonth #HealthcarePlanning #MelanomaCare #PreventiveInterventions 🏥

skin cancer primary prevention

Enhancing Skin Cancer Prevention in a Primary Care Setting

🌞 Discover the latest strategies in skin cancer primary prevention! From innovative risk assessment tools to new technologies, learn how primary care can play a pivotal role in reducing skin cancer rates.
🩺👩‍⚕️👨‍⚕️ #SyenzaNews #Healthcare #SkinCancerPrevention #PrimaryCare #Innovation

Valvular heart disease in Saudi Arabia

Addressing Valvular Heart Disease in Saudi Arabia

#SyenzaNews 🚀 Valvular heart disease (VHD) is a growing concern in Saudi Arabia, especially among the ageing population.
Discover the current challenges and actionable recommendations to enhance VHD care.

Let’s work together to improve awareness, detection, and treatment! #Healthcare #Cardiology #SaudiArabia #HealthyAging 🌟

When you partner with Syenza, it’s like a Nuclear Fusion.

Our expertise are combined with yours, and we contribute clinical expertise and advanced degrees in health policy, health economics, systems analysis, public finance, business, and project management. You’ll also feel our high-impact global and local perspectives with cultural intelligence.



1950 W. Corporate Way, Suite 95478
Anaheim, CA 92801, USA



© 2024 Syenza™. All rights reserved.