Transport Rates and Prehospital Intervals for an EMS Telemedicine Intervention.

Area of Science:

• Emergency Medicine
• Telehealth
• Health Services Research

Background:

• Emergency medical services (EMS) telemedicine is proposed to decrease hospital transports for 9-1-1 callers.
• Key uncertainties include identifying patient conditions suitable for in-place treatment and the impact of telemedicine on prehospital time intervals.

Purpose of the Study:

• To assess the association between EMS clinicians' impressions and transport avoidance.
• To determine the effect of telemedicine encounters on prehospital time intervals.

Main Methods:

• Retrospective review of EMS records from two commercial agencies.
• Matched-pair analysis comparing telemedicine encounters with non-telemedicine cases.
• Mapping clinician impressions to the International Classification of Primary Care, 2nd edition (ICPC-2).

Main Results:

• 67% of 463 prehospital telemedicine evaluations avoided hospital transport.
• Respiratory conditions were most likely to be treated in place (p=0.018).
• Telemedicine without transport reduced prehospital intervals by a median of 16 minutes compared to matched pairs; telemedicine with transport increased intervals by 27 minutes.

Conclusions:

• Prehospital telemedicine effectively reduces hospital transports, particularly for respiratory conditions.
• Telemedicine encounters were associated with a median 4-minute reduction in prehospital interval per call.
• Further research is needed on the long-term patient outcomes of prehospital telemedicine.