The case for tele-emergency services

by Bill Barker

New research from the University of Iowa supports the claim that tele-emergency services can successfully extend emergency care in rural hospitals. A summary of the research was published in the new February edition of Health Affairs.

Tele-emergency is the urgent care component of telehealth, a term used to describe services consisting of diagnosis, treatment, assessment, monitoring, communications, and education of medical conditions via digital technologies like videoconferencing. Telehealth can deliver important medical services where they are needed most, and remove barriers of time, distance, and limited providers. This includes remote, rural areas and medically underserved urban communities.

"Tele-emergency improves through integrated services that deliver the right care at the right time and the right place," says Keith Mueller, professor in the UI's College of Public Health and the study's lead author. "Our country's is in a massive state of change, and it's through services such as this that we'll be able to address patient need and assist in the financial concerns of smaller medical care units."

As part of the research, the authors conducted an evaluation of a widely implemented tele-emergency service in the upper Midwest that provides 24/7 connection between an urban "hub" emergency department (ED) and 71 remote hospitals. At any time, clinical staff members at the remote hospitals can press a button for immediate, synchronous audio/video connection to the tele-emergency hub ED.

Through surveys, phone interviews, and site visits, Mueller and his team found that 95 percent of respondents felt that "tele-emergency improves the quality of care at my facility." In addition, tele-emergency services served as a forum for physicians to seek second opinions and improved adherence to evidence-based clinical protocols.

"Telehealth technology, including tele-emergency, addresses shortcomings in and facilitates improvements in patient care," says Marcia Ward, professor of health management and policy and a co-author on the evaluation. "If its potential is realized, telehealth will be integral to transforming the delivery system in ways that are consistent with an emphasis on increasing value and reducing the total cost of care."

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