Feasibility of a Pre-Hospital Virtual Triage and Care Model: A Mixed-Methods Pilot in Emergency Care

To date, research on pre-hospital telehealth has primarily been observational or conducted in controlled settings. This study examines the feasibility of a novel pre-hospital telehealth initiative-the Virtual Triage Assessment and Care (VTAC) model-and its potential impact on the efficiency of patient flow through the emergency department (ED). This study aims to contribute evidence regarding the practical implementation and outcomes of pre-hospital telehealth interventions in real-world settings.

This study adopted a mixed method approach to combine data from electronic medical records, observations and surveys across a breadth of stakeholders. Quantitative data were analysed in a matched cohort analysis. Qualitative data were inductively themed and triangulated.

Twenty-six patients were identified as eligible for VTAC, and it was successfully piloted in 10 patient cases over 3 days in October 2023. Pilot evidence suggests that virtual patient review following ambulance retrieval enabled senior medical assessment 81 min earlier and expedited diagnostic orders, facilitating earlier treatment planning and resulting in a 14% (50 min) reduction in emergency department length of stay. However, no significant improvements were observed in Queensland Ambulance Service crew cycle times. Patients reported high satisfaction with VTAC, with all surveyed agreeing telehealth was an acceptable triage method.

Early data indicates that the VTAC model is feasible and may support ED patient journey efficiencies. It further identifies several real-world enablers for integration into practice, including greater availability of critical technologies and governance structures that integrate virtual workflows with current ED processes.