Developing telemedicine in Emergency Medical Services: A low-cost solution and practical approach connecting interfaces in emergency medicine

Abstract

Background: In Germany, the number of calls for Emergency Medical Services (EMS) are increasing, while the number of general practitioners and hospitals are decreasing, resulting in a growing demand and workload for emergency physicians and paramedics. Furthermore, an aging population with increasingly complex medical histories, present emergencies in which a more detailed assessment and therapies are urgently needed. Therefore, common EMS systems need to find solutions to handle these problems. Methods: We used a user-focused five-step approach to define a technological solution: Research of current systems, definition of goals and requirements, development of concept, test series and evaluation, evaluation of costs and benefits. Results: Development of a holistic telemedical concept to connect in-hospital clinical emergency physicians and paramedics on the scene, by implementing and connecting systems that are already partially being used in common EMS in Germany. By using live audio and video communication, including vital signs between the two, a system can be established by keeping costs low, affordable and at the same time protecting patient data in line with General Data Protection Regulation. Conclusion: Implementing technologies in a practical specialty like Emergency Medicine with a user-focused approach demonstrates that the hurdle for integration into established routines can improve current processes. Evaluation of costs and usability is a main driver to define success of such concepts and can improve if such systems can be developed to be used in larger networks.

Improving the introduction of telemedicine in pre-hospital emergency medicine: Understanding users and how Acceptability, Usability and Effectiveness influence this process

“…With current systems -especially in Germany-only replacing the physically available emergency physician, a network solution -such as an emergency talk network [24]-could allows many specialists to be available rapidly within one system.…”

“…While current German laws and medical legislation requires patients in the pre-hospital eld to be seen by a physician, ideally a GP, these primary care physicians are also faced with an increasing amount of patients and structural changes [22,23]. In a recent survey in which not only physicians but also local german politicians and administrators where questioned, these seemed to support the idea of using telemedicine for the primary care sector and limit its application not only to rural areas [16,24]. Therefore a telemedical solution could not only provide a replacement for an in-person visit by an Emergency Physician, but would rather further the idea of developing a digital network that could connect patients with an adequate healthcare provider.…”

“…Following this strategy of developing an emergency network this could therefore connect not only EDs with EMS but also involve other specialist structures like paediatricians (or even heart catheter laboratories or palliative care teams etc.) in a digital emergency medical network-an emergency Talk Network (ETN) [24]. Such an approach could optimise the ow of patients, the use of available limited resources, improve the safety of patients as well as guideline adherence.…”

Telemedicine in Emergency Medicine in the COVID-19 Pandemic—Experiences and Prospects—A Narrative Review

“…Telemedicine has the potential to improve the quality of prehospital emergency medical services by addressing triage and by collaboration with local and governmental emergency services providers [13]. Pre-hospital telehealth systems have been developed to provide faster, more efficient care for COVID-19 patients triaged to appropriate levels of care.…”

Comparing the effects and application of telemedicine in emergency medicine for different medical specialties using the Emergency Talk Application in the U-Sim ETA Trial

“…Also the environment for telemedical system vary as they depends on regional emergency medical structures including geography but also on laws, data protection regulations but especially on standardized medical treatment options which paramedics are allowed to provide [14][15][16][17][18][19][20].…”