Perceptions and Perceived Utility of Rural Emergency Department Telemedicine Services: A Needs Assessment

Access to specialized medical care is often limited in rural emergency departments (EDs). Specialist consultation through telemedicine services could help increase access in low-resource areas. The objective of this study was to better understand providers' perceptions of the anticipated impact of telemedicine in rural Midwestern EDs. The secondary objective was to understand differences in the perception of rural and academic providers in their views of the utility of telemedicine. We conducted a survey of medical providers including physicians, physician assistants, and nurse practitioners at five rural Midwestern critical access hospitals and within six departments at a university medical center in the same region. The survey addressed opinions on telemedicine, including how often it would be used and the potential to improve patient care and reduce transfers. Specialties of high perceived utility to rural providers include psychiatry, cardiology, and neurology; whereas academic providers viewed services in psychiatry, pediatric critical care, and neurology to be of the most potential value. Academic and rural providers have differing opinions on the anticipated frequency of telemedicine use (p < 0.001) and prevention of inter-hospital transfers (p = 0.023). There were significant differences in perceived value by specialty. There is a high demand for telemedicine consultation services in rural Midwestern hospitals, particularly in psychiatry, cardiology, and neurology. Overall, academic providers view telemedicine services as more valuable within their specialty than do rural providers. Further research should be done to investigate individualization of telehealth services based on regional needs and how disparate opinions predict telemedicine utilization.