A recent study from the University of Iowa, published in Telemedicine and e-Health concluded that the use of telemedicine in rural emergency department decreased the “door-to-provider” time and the overall time spent in the ER for patients that required transfer to another hospital. The study was conducted at Critical Access Hospitals which are rural location emergency departments that may not have a medical provider in the hospital 24 hours per day. In some situations, this meant that the telemedicine provider was the first provider to see a patient.
Overall, the door-to-provider time for cases where telemedicine was used was less than 1/2 the time it took to be seen by an in-person provider. For specialist consulting cases, the telemedicine consultant was present before the in-person provider nearly 42% of the time and an average of about 15 minutes sooner than the in-person provider. Some of these cases involved activating telemedicine even before the patient arrives in situations where an ambulance report indicated the need to trigger a telemedicine provider consult.
Additionally, because the telemedicine provider was apart of the hospital system that received the transfers from the rural hospitals, the overall length of time spent in the ER for transferred patients was about 22 minutes shorter. Not adequately addressed in this study though is why the average ER stay for patients that were not transferred ended up being about 40 minutes longer in patient seen by telemedicine.
This study does provide a generally positive outlook for telemedicine’s use in rural facilities. Telemedicine providers can provide the initial rapid response in hospitals that do not have a 24 hour emergency physician and get studies started before the arrival of the onsite provider. They may also be able to assist during busy time frames when the ER is crowded with patients, essentially providing an intermittent surge provider to help the onsite provider during overwhelming conditions.