Journal article
The Effect of Sepsis Recognition on Telemedicine Use in Rural Emergency Department Sepsis Treatment
Telemedicine journal and e-health, Vol.31(7), 0281
06/30/2025
DOI: 10.1089/tmj.2024.0281
PMID: 40106305
Abstract
Provider-to-provider emergency department telehealth (tele-ED) has been proposed to improve rural sepsis care. The objective of this study was to measure the association between sepsis documentation and tele-ED use, treatment guideline adherence, and mortality.
This analysis was a multicenter (
= 23) cohort study of sepsis patients treated in rural emergency departments (EDs) that participated in a tele-ED network between August 2016 and June 2019. The primary outcome was whether sepsis was documented explicitly in the clinical note impression in the local ED, and the primary exposure was rural tele-ED use, with secondary outcomes of time to tele-ED use, 3-h guideline adherence, and in-hospital mortality.
Data from 1,146 rural sepsis patients were included, 315 (27%) had tele-ED used and 415 (36%) had sepsis recognized in the rural ED. Tele-ED use was not independently associated with sepsis recognition (adjusted odds ratio [aOR]: 1.23, 95% confidence interval [CI]: 0.90-1.67). Sepsis recognition was associated with earlier tele-ED activation (adjusted hazard ratio 1.66, 95% CI: 1.28-2.15) and greater 3-h guideline adherence (aOR 1.37, 95% CI 1.03-1.83) Sepsis recognition was not independently associated with mortality (aOR 1.32, 95% CI 0.97-1.80).
Although tele-ED care is a promising strategy to improve sepsis outcomes, its use was limited by under-recognition of sepsis in rural EDs.
Details
- Title: Subtitle
- The Effect of Sepsis Recognition on Telemedicine Use in Rural Emergency Department Sepsis Treatment
- Creators
- Anna M Kaldjian - University of IowaPriyanka Vakkalanka - University of IowaUche Okoro - University of IowaCole Wymore - University of IowaKarisa K Harland - University of IowaKalyn Campbell - University of MinnesotaMorgan B Swanson - University of IowaBrian M Fuller - Washington University in St. LouisBrett Faine - University of IowaAnne Zepeski - University of IowaEdith A Parker - University of IowaLuke Mack - University of Sioux FallsAmanda Bell - University of Sioux FallsKatie DeJong - University of Sioux FallsKelli Wallace - University of IowaKeith Mueller - University of IowaElizabeth Chrischilles - University of IowaChristopher R Carpenter - Mayo ClinicMichael P Jones - University of IowaMarcia M Ward - University of IowaNicholas M Mohr - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.31(7), 0281
- DOI
- 10.1089/tmj.2024.0281
- PMID
- 40106305
- NLM abbreviation
- Telemed J E Health
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Publisher
- Mary Ann Liebert
- Grant note
- Agency for Healthcare Research and Quality: K08HS025753 Institute for Clinical and Translational Science at the University of Iowa through National Center for Advancing Translational Sciences at the National Institutes of Health: UL1TR002537 University of Iowa Department of Emergency MedicineRural Telehealth Research CenterHealth Resources and Services Administration: U3GRH40003
This study was funded by the Agency for Healthcare Research and Quality (K08HS025753), the Institute for Clinical and Translational Science at the University of Iowa through a grant from the National Center for Advancing Translational Sciences at the National Institutes of Health (UL1TR002537), and the University of Iowa Department of Emergency Medicine. N.M.M. is additionally supported by funding from the Rural Telehealth Research Center with funding from the Health Resources and Services Administration (U3GRH40003).
- Language
- English
- Electronic publication date
- 03/19/2025
- Date published
- 06/30/2025
- Academic Unit
- Pharmacy; Public Health Administration; Health Management and Policy; Biostatistics; Pharmacy Practice and Science; Center for Social Science Innovation; Anesthesia; Injury Prevention Research Center; Statistics and Actuarial Science; Rural Telehealth Research Center; Epidemiology; Emergency Medicine; Community and Behavioral Health; Law Faculty
- Record Identifier
- 9984801667302771
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