A systematic review of prehospital telehealth utilization

Abstract

Objective There has been moderate evidence of telehealth utilization in the field of emergency medicine, but less is known about telehealth in prehospital emergency medical services (EMS). The objective of this study is to explore the extent, focus, and utilization of telehealth for prehospital emergency care through the analysis of published research. Methods The authors conducted a systematic literature review by extracting data from multiple research databases (including MEDLINE/PubMed, CINAHL Complete, and Google Scholar) published since 2000. We used consistent key search terms to identify clinical interventions and feasibility studies involving telehealth and EMS, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results We identified 68 articles focused specifically on telehealth interventions in prehospital care. The majority (54%) of the studies involved stroke and acute cardiovascular care, while only 7% of these (4) focused on telehealth for primary care. The two most common delivery methods were real-time video-conferencing capabilities (38%) and store and forward (25%); and this variation was based upon the clinical focus. There has been a significant and positive trend towards greater telehealth utilization. European telehealth programs were most common (51% of the studies), while 38% were from the United States. Discussion and Conclusions Despite positive trends, telehealth utilization in prehospital emergency care is fairly limited given the sheer number of EMS agencies worldwide. The results of this study suggest there are significant opportunities for wider diffusion in prehospital care. Future work should examine barriers and incentives for telehealth adoption in EMS.

Prehospital Telemedical Emergency Management of Severely Injured Trauma Patients

“…79,80 Previous reviews in acute trauma care identified telemedical assistance by remote medical expertise as prominent telemedical modality and included mostly cases studies. These findings match those observed by Winburn et al, 81 that the most used telemedical application in prehospital care was real-time video-conferencing. Rogers et al included also four of the studies that were analysed in this review, 64,65,68,71 but categorized them into general care.…”

Assessment of the health care system functioning in Poland in light of the analysis of the indicators of the hospital emergency department (ED) and primary health care (PHC) – proposals for systemic solutions

“…The results suggest there are significant opportunities for wider diffusion of telehealth in pre-hospital care. The authors concluded that despite positive trends, telehealth utilisation in pre-hospital emergency care is fairly limited given the sheer number of EMS agencies worldwide [71]. In the study of Langabeer et al, patient care enabled by telehealth in a pre-hospital environment was more cost-effective alternative compared to the traditional EMS 'treat and transport to ED' model.…”

Cross-sectional Study of the Ambulance Transport Between Healthcare Facilities With Medical Support via Telemedicine: Easy, Effective, Low-cost, and High-security Tool

“…There exists evidence to suggest that teleconsultation assessment bene ts virtually all medical scenarios, including ambulance transportation [8]. In a prehospital setting, the support TM lends to the ambulance team is associated with a reduction in ED referral [9]. Video communication between the ambulance and the ED may boost the local staff's perception of clinical status and jump-start triage [10].…”