Journal article
Emergency Department Telemedicine Shortens Rural Time-To-Provider and Emergency Department Transfer Times
Telemedicine journal and e-health, Vol.24(8), pp.582-593
08/01/2018
DOI: 10.1089/tmj.2017.0262
PMID: 29293413
Abstract
Background:
Emergency department (ED)-based telemedicine has been implemented in many rural hospitals to provide specialty care and expertise to patients with critical time-sensitive conditions.
Introduction:
The purpose of this study was to measure the impact of ED-based telemedicine on timeliness of care in participating rural hospitals.
Materials and Methods:
Matched cohort study of patients seen in 1 of 14 rural hospitals in a large Midwestern telemedicine network. Telemedicine cases were matched 2:1 with controls based on age, diagnosis, and hospital. The primary outcome was door-to-provider time, and secondary outcomes included ED length-of-stay (LOS) and time-to-transfer in those transferred to other hospitals.
Results:
Of 127,928 qualifying ED encounters, 2,857 consulted telemedicine and were matched with nontelemedicine controls. Door-to-provider time was shorter in telemedicine patients by 6.0 min (95% confidence interval [CI] 4.3–7.8 min). The first provider seeing the patient was a telemedicine provider in 41.7% of telemedicine encounters, and in these cases, telemedicine was 14.7 min earlier than local providers. ED LOS was 22.1 min shorter (95% CI 3.1–41.2) among transferred patients, but total ED LOS was longer (40.2 min, 95% CI 30.8–49.6 min) for all telemedicine patients.
Conclusions:
Telemedicine decreases ED door-to-provider time, most commonly because the telemedicine provider was the first provider seeing a patient. Among transferred patients, ED LOS at the first hospital was shorter in patients who had telemedicine consulted. Future work will focus on the clinical impact of more timely rural ED care.
Details
- Title: Subtitle
- Emergency Department Telemedicine Shortens Rural Time-To-Provider and Emergency Department Transfer Times
- Creators
- Nicholas M Mohr - 3Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IowaTracy Young - 4Injury Prevention Research Center, University of Iowa College of Public Health, Iowa City, IowaKarisa K Harland - 1Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaBrian Skow - 5Avera eCARE, Sioux Falls, South DakotaAmy Wittrock - 5Avera eCARE, Sioux Falls, South DakotaAmanda Bell - 5Avera eCARE, Sioux Falls, South DakotaMarcia M Ward - 6Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.24(8), pp.582-593
- DOI
- 10.1089/tmj.2017.0262
- PMID
- 29293413
- NLM abbreviation
- Telemed J E Health
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Publisher
- Mary Ann Liebert, Inc
- Language
- English
- Date published
- 08/01/2018
- Academic Unit
- Rural Telehealth Research Center; Occupational and Environmental Health; Health Management and Policy; Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center; Public Policy Center (Archive); Law Faculty
- Record Identifier
- 9984025285002771
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