Four Years' Experience of Telemedicine Support of a Minor Accident and Treatment Service

Abstract

In 1996 we studied patients attending a minor accident and treatment service in London, some of whom were the subjects of teleconsultations with a main hospital emergency department. In the subsequent four years, 56,139 patients were seen at the minor accident and treatment service unit. Teleconsultations were performed in 2032 cases (3.6%). Most of the teleconsultations (58%) concerned patients with fractures. The main reason for teleconsultation was to review and discuss radiographs (46%). In comparison with the 1996 study, both the emergency nurse practitioners and the consultant had improved the accuracy of their teleradiology diagnosis, although the difference was not significant. Most of the telemedicine patients (90%) did not need a transfer to the main department. Thus telemedicine allowed local decision making in the majority of cases. In the 1996 survey, 75% of patients were sent to their general practitioner or to the main hospital department; in the present survey, this proportion had halved, to 38%. The present study showed that teleconsultations are an effective way of preventing patients being transferred unnecessarily from a minor accident and treatment service to the main hospital accident and emergency department.

The Use of Patient-Facing Teleconsultations in the National Health Service: Scoping Review

“…Where articles commented on the efficacy, safety or other clinical outcomes, these were categorized as assessing the clinical effectiveness of teleconsultations in delivering health care. There were 48 articles of which there were 12 pilots [14,15,30,34,43,48,62,63,65,86,88,108], 5 case reports/series [19,22,36,72,99], 7 case-controls [28,42,44,49,53,69,78], 1 qualitative study [10], 2 mixed method [102,105], 4 retrospective studies [35,58,80,92] [54], 1 descriptive study [90], and 1 service report [96].…”

“…In an A&E setting, an RCT found no significant differences in diagnostic accuracy or management when teleconsultations were compared with the traditional model of care [64]. In minor injury units, the use of teleconsultations, connecting with a regional A&E center, allowed the majority of patients to be managed locally, with continued improvements seen with increasing technological familiarity [48,58,62,65].…”

Nurse-to-family telehealth for pediatric transfers: protocol for a feasibility and pilot cluster randomized controlled trial

“…The use of telehealth to bring a pediatric provider virtually to the child's bedside in the ED has the potential to promote more family-centered care during transfers and to mitigate distress and triage issues [5,[14][15][16][17][18]. In this protocol report, telehealth refers to information exchange from one site to another using HIPAA-compliant videoconference technology [19].…”

Development of a Broadband Telehealth System for Critical Care: Process and Lessons Learned

“…Since the 1970s, telehealth technologies have helped offsite specialists to remotely monitor and manage the care of critically ill patients. 1 Teleconsultations have been used to assist in trauma patient care in the emergency department [2][3][4][5] to monitor patients continuously in the intensive care unit (ICU), 6,7 and to manage pediatric critical care 8 by using narrow-or broad-band Integrated Services Digital Network (ISDN). The effectiveness of critical care telehealth systems is being enhanced by integration of more functions 10 and introducing new technologies.…”