Telemedicine Utilization in Rural Trauma Care and Its Effects on Secondary Overtriage Rates: A Concise Review

Rural areas face a disproportionate trauma burden, with patients injured outside urban centers experiencing a 14% higher mortality rate, primarily because of long distances, transport delays, and limited specialist availability that hinder timely, high-quality care. Studies show that roughly one-quarter to nearly one-half of interfacility transfers from rural hospitals qualify as secondary overtriage.

This concise review aims to evaluate the impact of telemedicine on secondary overtriage and its associated patient outcomes, barriers to telemedicine implementation, and subsequent financial implications in rural trauma care settings.

Our review searched 5 databases, screening articles published before July 7, 2025. Studies focusing on evaluating the effects of telemedicine in rural adult trauma settings were included.

A total of 7 articles met the inclusion criteria. The implementation of teletrauma in rural hospitals resulted in decreased interfacility transfer rates to higher-level facilities, with up to 89% of patients being treated locally without transfer and without an associated increase in mortality or hospital length of stay (2.1 days vs. 2.2 days) between transferred and nontransferred patients. Barriers to telemedicine implementation included licensure, technological reliability, and initiation costs. In addition, preliminary evidence from 2 single-site studies suggests that telemedicine may reduce both hospital expenditures for the trauma center ($7,632,624-$1,126,683, p < .001) and interfacility transfer costs ($47,233 vs. $34,017, p < .0001), although further multisite research is needed to confirm these findings.

Despite existing barriers, telemedicine in rural trauma presents the potential to decrease unnecessary transfers without adversely affecting clinical outcomes, with early evidence suggesting meaningful financial benefits for rural trauma facilities.