Emergency physicians' roles in a clinical telemedicine network.

Abstract

To study the roles emergency physicians have in a clinical telemedicine network. A descriptive analysis of telemedicine consultations conducted by emergency physicians at 1 year of operation of a private clinical telemedicine program. From February 1, 1995, to February 1, 1996, 190 clinical telemedicine consultations were completed. Emergency medicine constituted the most common specialty consulted, accounting for 45 (24%) of the consultations. All consultations were one-time transmissions and interactions. They ranked as follows: trauma or orthopedic care, 33 (73%); adult medical problems, 6 (13%); and pediatric medical problems, 6 (13%). Of the emergency medicine teleconsultations, 39 (87%) were categorized as emergency (completed immediately). Of the emergency medicine consultations completed, 24 (53%) patients remained in the rural community, and 21 (47%) were transferred to the tertiary care facility for additional care. The primary peripheral used for emergency medicine teleconsultations was a one-chip document camera. Forty-three (96%) of the emergency medicine teleconsultations involved radiograph interpretations. The most common radiographs reviewed were of the arm, 14 (33%); leg, 10 (23%); and cervical spine, 7 (16%). There was one minor radiograph interpretation discrepancy. Of the emergency medicine teleconsultations, 65% occurred between 7 PM and 8 AM. Of emergency medicine teleconsultations, 24% were completed on Saturdays and Sundays, with 26% of consultations being completed on Fridays. All emergency physicians involved in telemedicine consultations were surveyed concurrently for satisfaction, future use, and recommendations for improvement. The technology afforded by telemedicine allows emergency physicians to participate in telemedicine consultations. Emergency physicians should consider using clinical telemedicine in their practice.