Tele-emergency utilization: In what clinical situations is tele-emergency activated?

Marcia M Ward; Fred Ullrich; A Clinton MacKinney; Amanda L Bell; Shiann Shipp; Keith J Mueller

doi:10.1177/1357633X15586319

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Tele-emergency utilization: In what clinical situations is tele-emergency activated?

Journal article

Peer reviewed

Tele-emergency utilization: In what clinical situations is tele-emergency activated?

Marcia M Ward, Fred Ullrich, A Clinton MacKinney, Amanda L Bell, Shiann Shipp and Keith J Mueller

Journal of telemedicine and telecare, Vol.22(1), pp.25-31

01/2016

DOI: 10.1177/1357633X15586319

PMID: 26026189

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Abstract

Tele-emergency provides audio/visual communication between a central emergency care centre (tele-emergency hub) and a distant emergency department (remote ED) for real-time emergency care consultation. The purpose of this mixed methods study is to examine how often tele-emergency is activated in usual practice and in what circumstances it is used. Tele-emergency log data and merged electronic medical record data from Avera Health (Sioux Falls, SD) were analysed for 60,193 emergency department (ED) encounters presenting over a two-and-a-half year period at 21 critical access hospitals using the tele-emergency service. Of these, tele-emergency was activated for 1512 ED encounters. Analyses indicated that patients presenting at rural EDs with circulatory, injury, mental and symptoms diagnoses were significantly more likely to have tele-emergency department services activated as were patients who were transferred to another hospital. Interviews conducted with 85 clinicians and administrators at 26 rural hospitals that used this service indicated that this pattern of utilization facilitated rapid transfers and followed recommended clinical protocols for patients needing serious and/or urgent attention (e.g. stroke symptoms, chest pain). Although only used in 3.5% of ED encounters on average, our findings provide evidence that tele-emergency activation is well reasoned and related to those situations when extra expert assistance is particularly beneficial.

Humans

Middle Aged

Rural Health Services - statistics & numerical data

Logistic Models

Male

Emergency Service, Hospital - statistics & numerical data

Hospital Bed Capacity - statistics & numerical data

Telemedicine - methods

Adult

Female

Hospitals, Rural - statistics & numerical data

Aged

Patient Admission - statistics & numerical data

Telemedicine - utilization

Details

Title: Subtitle: Tele-emergency utilization: In what clinical situations is tele-emergency activated?
Creators: Marcia M Ward - Department of Health Management and Policy, University of Iowa, USA marcia-m-ward@uiowa.edu
Fred Ullrich - Department of Health Management and Policy, University of Iowa, USA
A Clinton MacKinney - Department of Health Management and Policy, University of Iowa, USA
Amanda L Bell - Avera Health, Sioux Falls, SD, USA
Shiann Shipp - Avera Health, Sioux Falls, SD, USA
Keith J Mueller - Department of Health Management and Policy, University of Iowa, USA
Resource Type: Journal article
Publication Details: Journal of telemedicine and telecare, Vol.22(1), pp.25-31
DOI: 10.1177/1357633X15586319
PMID: 26026189
NLM abbreviation: J Telemed Telecare
ISSN: 1357-633X
eISSN: 1758-1109
Publisher: England
Language: English
Date published: 01/2016
Academic Unit: Rural Telehealth Research Center; Health Management and Policy; Public Policy Center (Archive)
Record Identifier: 9984063137502771

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