Tele-Emergency Services in the Himalayas.

Area of Science:

• Remote Healthcare
• Telemedicine Innovations
• Emergency Medical Services

Background:

• Access to emergency healthcare is limited in remote, mountainous, and sparsely populated areas.
• A novel Tele-emergency service (TES) was implemented in Keylong and Kaza, Himachal Pradesh, India.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of delivering Tele-emergency services in challenging, high-altitude terrains.
• To assess the impact of TES on emergency care outcomes and community reception.

Main Methods:

• Existing hospital and health center rooms were converted into tele-emergency centers.
• These centers were linked to a tertiary care hospital 2,925 km away.
• Tele-ECG, Spirometry, and Point-of-Care Diagnostics were utilized, with staff training provided at both ends.

Main Results:

• Over 35 months, 753 emergency teleconsults were provided, with an average turnaround time under 12 minutes.
• Remote diagnostics facilitated timely interventions, including thrombolysis for myocardial infarction and cardioversion for supraventricular tachycardia.
• 196 patients were stabilized and transferred, with 13 requiring helicopter evacuation; the average cost per emergency teleconsult was $208.

Conclusions:

• Delivering Tele-emergency services in inhospitable terrains via Public-Private Partnership is a viable model.
• The community welcomed the TES initiative, indicating its value in underserved remote areas.