Examining the Emergency Medical Treatment and Active Labor Act: impact on telemedicine for neurotrauma

Abstract

The Emergency Medical Treatment and Active Labor Act (EMTALA) protects patient access to emergency medical treatment regardless of insurance or socioeconomic status. A significant result of the COVID-19 pandemic has been the rapid acceleration in the adoption of telemedicine services across many facets of healthcare. However, very little literature exists regarding the use of telemedicine in the context of EMTALA. This work aimed to evaluate the potential to expand the usage of telemedicine services for neurotrauma to reduce transfer rates, minimize movement of patients across borders, and alleviate the burden on tertiary care hospitals involved in the care of patients with COVID-19 during a global pandemic. In this paper, the authors outline EMTALA provisions, provide examples of EMTALA violations involving neurosurgical care, and propose guidelines for the creation of telemedicine protocols between referring and consulting institutions.

The Legal and Socioeconomic Considerations in Spine Telemedicine

“…27 From 2002 to 2015, an estimated 167 to 192 Emergency Medical Treatment and Active Labor Act violations resulted in settlements amounting to US$31 000 on average. 27 Increased access to spine care for patients in rural areas can also result from the proper use of telemedicine. People with spinal cord injuries living in nonurban areas, for example, may be less likely to receive quality diagnostics and treatments from local facilities.…”

“…27 From 2002 to 2015, an estimated 167 to 192 Emergency Medical Treatment and Active Labor Act violations resulted in settlements amounting to US$31 000 on average. 27…”

“…18 Reducing unnecessary transfers may decrease the chances of receiving hospitals refusing appropriate transfers because of being overwhelmed by unnecessary ones. 27 At the same time, receiving hospitals would be able to deny inappropriate transfers, without possibly violating the Emergency Medical Treatment and Active Labor Act, which prevents denial of patient access to emergency medical treatment regardless of their socioeconomic or insurance status. 27 From 2002 to 2015, an estimated 167 to 192 Emergency Medical Treatment and Active Labor Act violations resulted in settlements amounting to US$31 000 on average.…”

“…27 At the same time, receiving hospitals would be able to deny inappropriate transfers, without possibly violating the Emergency Medical Treatment and Active Labor Act, which prevents denial of patient access to emergency medical treatment regardless of their socioeconomic or insurance status. 27 From 2002 to 2015, an estimated 167 to 192 Emergency Medical Treatment and Active Labor Act violations resulted in settlements amounting to US$31 000 on average. 27 Increased access to spine care for patients in rural areas can also result from the proper use of telemedicine.…”