Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct;18(6):1055-1060.
doi: 10.5811/westjem.2017.8.34880. Epub 2017 Sep 11.

Characterizing New England Emergency Departments by Telemedicine Use

Kori S Zachrison  1 , Emily M Hayden  1 , Lee H Schwamm  2 , Janice A Espinola  1 , Ashley F Sullivan  1 , Krislyn M Boggs  1 , Ali S Raja  1 , Carlos A Camargo Jr  1
Affiliations

Characterizing New England Emergency Departments by Telemedicine Use

Kori S Zachrison et al. West J Emerg Med. 2017 Oct.

Abstract

Introduction: Telemedicine connects emergency departments (ED) with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use.

Methods: We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195) in the six New England states (excluding federal hospitals and college infirmaries). Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use.

Results: Of the 169 responding EDs (87% response rate), 82 (49%) reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03); less likely to be academic (1% of users vs. 11% of non-users, p=0.01); and less likely to have 24/7 access to neurology (p<0.001), neurosurgery (p<0.001), orthopedics (p=0.01), plastic surgery (p=0.01), psychiatry (p<0.001), and hand surgery (p<0.001) consultants. Neuro/stroke (68%), pediatrics (11%), psychiatry (11%), and trauma (10%) were the most commonly reported applications. On multivariable analysis, telemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30-14.86), and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09-0.49]), and annual volume <20,000 (OR 0.24, 95% CI [0.08-0.68]).

Conclusion: Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. Dr. Sauser Zachrison reports funding from AHRQ (K08HS024561) and the American Heart Association (16MCPRP27260221). Dr. Schwamm reports being a consultant to LifeImage, a privately held teleradiology start-up company, and the Medical Director of TeleHealth as part of his employment at the Massachusetts General Hospital.

Figures

Figure
Figure
Free responses as reported by responding EDs converted to categorical variable. Type of telemedicine (TM) use reported by TM-using EDs, n=82.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Marcin JP, Shaikh U, Steinhorn RH. Addressing health disparities in rural communities using telehealth. Pediatr Res. 2016;79(1–2):169–76. - PubMed
    1. Sanders, Jason LJ, Raja AS, et al. Decline in consultant availability in Massachusetts Emergency Departments: 2005 to 2014. Ann Emerg Med. 2016;68(4):461–6. - PubMed
    1. The Role of Telehealth in an Evolving Health Care Environment - Workshop Summary [Internet] National Academies Press; 2012. [Accessed December 13, 2016]. Available at: http://www.nationalacademies.org/hmd/Reports/2012/The-Role-of-Telehealth.... - PubMed
    1. Ward M, Jaana M, Natafgi N. Systematic review of telemedicine applications in emergency rooms. Int J Med Inf. 2015;84(9):601–16. - PubMed
    1. Schwamm LH, Holloway RG, Amarenco P, et al. A review of the evidence for the use of telemedicine within stroke systems of care: a Scientific Statement from the American Heart Association/American Stroke Association. Stroke. 2009;40(7):2616–34. - PubMed

MeSH terms

LinkOut - more resources