Journal article
The role of telehealth in sepsis care in rural emergency departments: A qualitative study of emergency department sepsis telehealth user perspectives
PloS one, Vol.20(4), e0321299
04/23/2025
DOI: 10.1371/journal.pone.0321299
PMCID: PMC12017570
PMID: 40267097
Abstract
Sepsis is a leading cause of hospitalization and death in the United States, and rural patients are at particularly high risk. Telehealth has been proposed as one strategy to narrow rural-urban disparities. The objective of this study was to understand why rural emergency department (ED) staff use provider-to-provider telehealth (tele-ED) and how tele-ED care changes the care for rural patients with sepsis.
We conducted a qualitative interview study between February 15, 2022, and May 22, 2023, with participants from upper Midwest rural EDs and tele-ED hub physicians in a single tele-ED network that delivers provider-to-provider consultation for sepsis patients. One interviewer conducted individual telephone interviews, then we used standard qualitative methods based on modified grounded theory to identify themes and domains.
We interviewed 27 participants, and from the interviews we identified nine themes within three domains. Participants largely felt tele-ED for sepsis was valuable in their practice. We identified that telehealth was consulted to facilitate interhospital transfer, provide surge capacity for small teams, to adhere with provider scope-of-practice policies, for inexperienced providers, and for patients with increased severity of illness or complex comorbidities. Barriers to tele-ED use and impact included increased sepsis care standardization, provider reluctance, and sepsis diagnostic uncertainty. Additionally, we identified that real-time education and training were important secondary benefits identified from tele-ED use.
Tele-ED care was used by rural providers for sepsis treatment, but many barriers existed that may have limited potential benefits to its use.
Details
- Title: Subtitle
- The role of telehealth in sepsis care in rural emergency departments: A qualitative study of emergency department sepsis telehealth user perspectives
- Creators
- Nicholas M Mohr - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, United States of AmericaKimberly A S Merchant - University of IowaBrian M Fuller - Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, United States of AmericaBrett Faine - University of IowaLuke Mack - University of South DakotaAmanda Bell - Avel eCARE, Sioux Falls, South Dakota, United States of AmericaKatie DeJong - Avel eCARE, Sioux Falls, South Dakota, United States of AmericaEdith A Parker - University of IowaKeith Mueller - University of IowaElizabeth Chrischilles - University of IowaChristopher R Carpenter - Department of Emergency Medicine, Mayo Clinical College of Medicine and Science, Rochester, Minnesota, United States of AmericaMichael P Jones - University of IowaSteven Q Simpson - University of KansasMarcia M Ward - University of Iowa
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.20(4), e0321299
- DOI
- 10.1371/journal.pone.0321299
- PMID
- 40267097
- PMCID
- PMC12017570
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- PUBLIC LIBRARY SCIENCE
- Grant note
- Agency for Healthcare Research and Quality (AHRQ): K08HS025753 Health Resources and Services Administration (HRSA): U3GRH40003
This study was supported by the Agency for Healthcare Research and Quality (AHRQ, K08HS025753) and Health Resources and Services Administration (HRSA, U3GRH40003) awarded to NM. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.
- Language
- English
- Date published
- 04/23/2025
- 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
- Record Identifier
- 9984813300402771
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