Four years' experience of telemedicine support of a minor accident and treatment service

Tachakra, Sapal; Uche, Chris Uko; Stinson, Alistair

doi:10.1258/135763302320302172

Cited by 13 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The increased discharges among moderate trauma patients, who were also less likely to be transferred, suggests the ViCCU is effective in identifying patients not requiring further care. United Kingdom studies of ED telemedicine systems to assess minor injuries have reported reduced patient transfers 9 and no negative effects in terms of return visits or need for additional care 3 . Increased transfers of critical care patients suggest that the ViCCU supported these decisions.…”

Section: Discussionmentioning

confidence: 99%

Impact of an ultrabroadband emergency department telemedicine system on the care of acutely ill patients and clinicians’ work

Westbrook

Coiera

Brear

et al. 2008

Medical Journal of Australia

View full text Add to dashboard Cite

Objectives: To evaluate whether introduction of an emergency department (ED) telemedicine system changed patient management and outcome indicators and to investigate clinicians’ perceptions of the impact of the system on care provided and on their work. Design: Before‐and‐after study of use of the Virtual Critical Care Unit (ViCCU), which uses an ultrabroadband connection allowing real‐time audiovisual communication between clinicians at distant sites. Semi‐structured interviews were conducted with medical and nursing staff at the end of the study. Participants and setting: The ViCCU intervention commenced on 1 January 2004. Our study was conducted in the EDs of an 85‐bed district hospital and a 420‐bed metropolitan tertiary hospital. It involved all acutely ill patients requiring urgent care (defined by triage category and grouped into critical care, major trauma and moderate trauma) who were treated during the 12 months before (n = 169) and 18 months after (n = 181) the intervention at the district hospital. Thirty‐one of 33 clinicians (doctors and nurses) participating at the two hospitals took part in interviews at the end of the study. Main outcome measures: Changes in patterns of management (disposition [admission, discharge or transfer], treatment times, number of procedures) and outcomes (rapid acute physiology scores, hours on ventilation or in intensive care, length of stay). Results: Patient disposition remained unaltered for major trauma patients. For critical care patients, admissions fell significantly (54% to 30%), transfers increased (21% to 39%), and more procedures were performed. For moderate trauma patients, discharges increased significantly (45% to 63%), transfers decreased (48% to 25%) and treatment times were longer. No significant changes were found in outcome indicators. Clinicians reported that the ViCCU allowed greater support to remote clinicians. Specialists reported increased workloads and feelings of greater responsibility for patients at the district hospital. Nurses at the district site reported reduced stress, but district doctors reported some loss of autonomy. Conclusions: The ViCCU appears most effective for moderate trauma patients, with associated reductions in admissions and transfers. Large‐scale trials of telemedicine systems that include measurements of both patient care and impact on clinicians’ work are required.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of an ultrabroadband emergency department telemedicine system on the care of acutely ill patients and clinicians’ work

Westbrook

Coiera

Brear

et al. 2008

Medical Journal of Australia

View full text Add to dashboard Cite

show abstract

“…Other services have implemented their telemedicine service to replace outreach clinics that already existed (25,72,(117)(118)(119) . The rest of the studies (n=19) (29,41,50,61,70,80,84,110,116,(120)(121)(122)(123)(124)(125)(126)(127)(128)(129) identified the need for additional clinical services -e.g. as a result of having a long waiting list-and explained how providing a telemedicine service would meet that need.…”

Section: Planning Based On Need Assessmentmentioning

confidence: 99%

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

AlDossary

Martin‐Khan

Bradford

et al. 2017

International Journal of Medical Informatics

108

View full text Add to dashboard Cite

Our systematic review identified only 137 telemedicine services. This suggests either telemedicine service implementation is still not a part of mainstream clinical services, or it is not being reported in the peer-reviewed literature. The depth and the quality of information were variable across studies, reducing the generalisability. The reporting of service implementation and planning strategies should be encouraged. Given the fast paced technology driven environment of telemedicine, this may enable others to learn and understand how to implement sustainable services. The key component of planning was underreported in these studies. Studies applying and reporting more rigorous methodology would contribute greatly to the evidence for telemedicine.

show abstract

“…Pediatric emergency telemedicine consultations can address this issue by providing on‐demand, synchronous videoconferencing between community ED clinicians and specialty hospital pediatricians . Such consultations can offer education, assistance, and reassurance to community physicians, thus improving care and disposition decisions and preventing some unnecessary transfers . With virtual face‐to‐face communication and a means for specialty providers to remotely assess the patient, telemedicine has advantages over telephone communication and can result in care that is of higher quality, more family‐centered, and more accessible …”

mentioning

confidence: 99%

Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program

Sauers‐Ford

Hamline

Gosdin

et al. 2019

Academic Emergency Medicine

View full text Add to dashboard Cite

Background: Pediatric emergency telemedicine consultations have been shown to provide support to community emergency departments treating critically ill pediatric patients. However, despite the recognized value of telemedicine, adoption has been slow. To determine why clinicians frequently do not use telemedicine when it is available for pediatric patients, as well as to learn how to improve telemedicine programs, we conducted a qualitative study using stakeholder interviews.Methods: We conducted a qualitative study using grounded theory methodology, with in-depth interviews of referring and accepting physicians and referring, transport, and transfer center nurses. We analyzed data iteratively and adapted the interview guide based on early interviews. We solicited feedback from the participants on the conceptual model.Results: Sixteen interviews were conducted; all respondents had been involved in a telemedicine consultation at least five times, with some having used telemedicine more than 30 times. Analysis resulted in three themes: 1) recognizing and addressing telemedicine biases are central to gaining buy-in; 2) as technology advances, telemedicine processes need to adapt accordingly; and 3) telemedicine increases collaboration among health care providers and patients/families in the patient care process.Conclusions: To improve patient care through increased use of telemedicine for pediatric emergency consultations, processes need to be modified to address provider biases and end-user concerns. Processes should be adapted to allow users to utilize a variety of technologies (including smartphones) and to enable more users, such as nurses, to participate. Finally, telemedicine can be used to improve the patient and family experience by including them in consultations.

show abstract

Four years' experience of telemedicine support of a minor accident and treatment service

Cited by 13 publications

References 0 publications

Impact of an ultrabroadband emergency department telemedicine system on the care of acutely ill patients and clinicians’ work

Impact of an ultrabroadband emergency department telemedicine system on the care of acutely ill patients and clinicians’ work

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program

Contact Info

Product

Resources

About