In reply
Davis and Jackson applaud us while questioning the value of our study1 because we examined the effectiveness of a multifaceted, comprehensive approach to tele-ICU care. They claim “such study design may invite persistent argument on the value of individual elements of care.” In our article we acknowledged that, because we studied a multifaceted intervention, we could not comment on the effectiveness of its individual components. However, we believe that studies examining the individual components of a tele-ICU approach would face other limitations. For example, if a particular component of an HITB were shown to have no effect on outcomes, when studied in isolation, it would still leave unanswered the question of whether that technology would be a necessary part of an effective, comprehensive HITB.