Game Time Consults: Piloting Telemedicine for Sideline Care in Rural High School Athletics

To assess the feasibility and clinical impact of sideline telemedicine for real-time injury assessment during high school athletic events in rural communities and to determine its potential effect on emergency department (ED) utilization.

Prospective, observational cohort study.

Three rural high schools in southeast Minnesota without on-site athletic trainer or emergency medical services coverage.

High school athletes and attendees injured during school-sponsored athletic events during the 2021 to 2022 school year.

Sideline telemedicine consults were initiated by school officials using tablets to connect with on-call dual board-certified emergency and sports medicine physicians. Consults included video-based assessment, triage, return-to-play guidance, and follow-up recommendations.

Disposition after consultation (return to play, outpatient follow-up, ED referral), satisfaction scores using the 10-item Telehealth Satisfaction Scale, and patient-reported intent to seek ED care if telemedicine were unavailable.

Telemedicine was activated 15 times. Most (53%) injuries were musculoskeletal. Two (13%) patients were referred to the ED, where time-sensitive diagnoses (NSTEMI, testicular torsion) were confirmed. Thirteen patients were treated without ED referral; 6 (46%) reported they would have otherwise visited the ED. All diagnoses were confirmed by outpatient follow-up. Telehealth Satisfaction Scale scores were high: interpersonal communication (mean 4.00), respectfulness (3.96), and technical quality (3.99).

Sideline telemedicine is a feasible and well-received model for acute injury evaluation at rural athletic events lacking on-site medical providers. It may reduce unnecessary ED use while preserving care quality and satisfaction, offering scalable support for resource-limited sports settings.