TY - JOUR
T1 - Telemedicine-based physician consultation results in more patients treated and released by ambulance personnel
AU - Raaber, Nikolaj
AU - Bøtker, Morten T
AU - Riddervold, Ingunn S
AU - Christensen, Erika F
AU - Emmertsen, Niels-Christian
AU - Grøfte, Thorbjørn
AU - Kirkegaard, Hans
PY - 2018/4
Y1 - 2018/4
N2 - OBJECTIVE: We examined whether teleconsultation from ambulances to a physician at an emergency medical communication center (EMCC) would increase the proportion of patients with nonurgent conditions being treated and released on site.METHODS: This research was a before-after pilot study. In the intervention period, the EMCC was manned 24/7 with physicians experienced in emergency care. Eligible participants included all patients with nonurgent conditions receiving an ambulance after a medical emergency call. Ambulance personnel assessed patients and subsequently performed a telephone consultation from the ambulance with the physician. The primary outcome was the proportion of patients treated and released on site. Secondary outcomes were the number of hospital admissions, mortality, and patient satisfaction. The intervention period was compared with a corresponding control period from the previous year.RESULTS: We observed an increase in the proportion of patients treated and released in the intervention period in 2014 compared with the control period in 2013, up from 21% (n=137) to 29% (n=221) (odds ratio=1.46; 95% confidence interval=1.14-1.89, P=0.002). The follow-up rate was 100%. There was no observable increase in hospital admissions or mortality among patients treated and released from 2013 to 2014. A telephone survey of patients treated and released showed that 98.4% (95% confidence interval=91.3-99.9) were very satisfied or satisfied with their treatment.CONCLUSION: Teleconsultation between a physician at the EMCC and ambulance personnel and noncritically ill 1-1-2 patients results in an increased rate of patients treated and released with high satisfaction. The approach does not seem to compromise patient safety.
AB - OBJECTIVE: We examined whether teleconsultation from ambulances to a physician at an emergency medical communication center (EMCC) would increase the proportion of patients with nonurgent conditions being treated and released on site.METHODS: This research was a before-after pilot study. In the intervention period, the EMCC was manned 24/7 with physicians experienced in emergency care. Eligible participants included all patients with nonurgent conditions receiving an ambulance after a medical emergency call. Ambulance personnel assessed patients and subsequently performed a telephone consultation from the ambulance with the physician. The primary outcome was the proportion of patients treated and released on site. Secondary outcomes were the number of hospital admissions, mortality, and patient satisfaction. The intervention period was compared with a corresponding control period from the previous year.RESULTS: We observed an increase in the proportion of patients treated and released in the intervention period in 2014 compared with the control period in 2013, up from 21% (n=137) to 29% (n=221) (odds ratio=1.46; 95% confidence interval=1.14-1.89, P=0.002). The follow-up rate was 100%. There was no observable increase in hospital admissions or mortality among patients treated and released from 2013 to 2014. A telephone survey of patients treated and released showed that 98.4% (95% confidence interval=91.3-99.9) were very satisfied or satisfied with their treatment.CONCLUSION: Teleconsultation between a physician at the EMCC and ambulance personnel and noncritically ill 1-1-2 patients results in an increased rate of patients treated and released with high satisfaction. The approach does not seem to compromise patient safety.
KW - emergency medical services
KW - remote consultation
KW - telemedicine
KW - telephone
KW - triage
KW - Patient Admission/statistics & numerical data
KW - Humans
KW - Ambulatory Care/statistics & numerical data
KW - Emergency Medical Technicians/organization & administration
KW - Pilot Projects
KW - Remote Consultation/organization & administration
KW - Emergency Medical Service Communication Systems/statistics & numerical data
KW - Health Services Accessibility/standards
UR - http://www.scopus.com/inward/record.url?scp=85044673136&partnerID=8YFLogxK
U2 - 10.1097/MEJ.0000000000000426
DO - 10.1097/MEJ.0000000000000426
M3 - Journal article
C2 - 27755124
SN - 0969-9546
VL - 25
SP - 120
EP - 127
JO - European Journal of Emergency Medicine
JF - European Journal of Emergency Medicine
IS - 2
ER -