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2020 ; 76
(5
): 602-608
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Telemedicine Facilitation of Transfer Coordination From Emergency Departments
#MMPMID32534835
Hayden EM
; Boggs KM
; Espinola JA
; Camargo CA Jr
; Zachrison KS
Ann Emerg Med
2020[Nov]; 76
(5
): 602-608
PMID32534835
show ga
STUDY OBJECTIVE: Interhospital transfers are costly to patients and to the health
care system. The use of telemedicine may enable more efficient systems by
decreasing transfers or diverting transfers from crowded referral emergency
departments (EDs) to alternative appropriate facilities. Our primary objective is
to describe the prevalence of telemedicine for transfer coordination among US
EDs, the ways in which it is used, and characteristics of EDs that use
telemedicine for transfer coordination. METHODS: We used the 2016 National
Emergency Department Inventory-USA survey to identify telemedicine-using EDs. We
then surveyed all EDs using telemedicine for transfer coordination and a sample
of EDs using telemedicine for other clinical applications. We used a
multivariable logistic regression model to identify characteristics independently
associated with use of telemedicine for transfer coordination. RESULTS: Of the
5,375 EDs open in 2016, 4,507 responded to National Emergency Department
Inventory-USA (84%). Only 146 EDs used telemedicine for transfer coordination; of
these, 79 (54%) used telemedicine to assist with clinical care for local
admission, 117 (80%) to assist with care before transfer, and 92 (63%) for
arranging transfer to a different hospital. Among telemedicine-using EDs, lower
ED annual visit volume (odds ratio 5.87, 95% CI 2.79 to 12.36) was independently
associated with use of telemedicine for transfer coordination. CONCLUSION:
Although telemedicine has potential to improve efficiency of regional emergency
care systems, it is infrequently used for coordination of transfer between EDs.
When used, it is most often to assist with clinical care before transfer.