Skip to main content
Top
Published in: Journal of Public Health 8/2023

27-01-2022 | Telemedicine | Review Article

Telemedicine in the emergency department: an overview of systematic reviews

Authors: Ali Sharifi Kia, Mouna Rafizadeh, Leila Shahmoradi

Published in: Journal of Public Health | Issue 8/2023

Login to get access

Abstract

Aim

There is both favorable and controversial evidence on the application of telemedicine in the emergency department (ED), which has created uncertainty regarding the effectiveness of these systems. We performed a systematic review of the literature on systematic reviews to provide an overview of the benefits and challenges to the application of telemedicine systems for the ED.

Subject and methods

PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were explored for systematic reviews of telemedicine applications for the ED. Each review was critically appraised by two authors for data items to be extracted and evaluated. The most highly recommended technology, feasibility, benefits, and challenges to the application of telemedicine systems were studied and reported.

Results

We identified 18 studies of varying methodological quality and summarized their key findings. Form these 18 studies, 12 papers yielded a high risk of bias in their investigation. Nine papers concluded that real-time video conferencing was the best method of delivery, eight papers found cost reduction as an outcome of implementing these systems, and six studies found technical and infrastructure issues as a challenge when implementing telemedicine for EDs.

Conclusion

There is strong evidence suggesting that the use of telemedicine positively impacts patient care. However, there are many challenges in implementing telemedicine that may impede the process or even impact patient safety. In conclusion, despite the high potential of telemedicine systems, there is still a need for better quality of evidence in order to confirm their feasibility in the ED.
Glossary
Real-time video & audio conference
Communications via an interactive conference between two or more participants at different sites, using computer networks or other telecommunication links to transmit audio, video, and data [1].
Store and Forward
Store-and-forward telemedicine is also called “asynchronous telemedicine.” It is a method by which healthcare providers share patient medical information with a physician, radiologist, or specialist at another location. It is not unlike email, but it is done using a solution that has built-in, sophisticated security features to ensure patient confidentiality [2].
Tele-monitoring
Transmission of patient vital and non-vital signs from patient site to the doctor. It is more suited for patients with chronic illnesses such as hypertension or diabetes [3].
Telepresence
Feeling present in a remote but real environment through telecommunications in order to perform tasks [4].
Tele-consultation
Synchronous or asynchronous consultation using information and communication technology to omit geographical and functional distance. Its goals are for diagnostics or treatment between two or more geographically separated health providers (for example, physicians or nurses) or between health providers and patients [5].
Tele-psychiatry
The practice of delivering psychiatric care using communications technology as a remote linkage between health-care providers and patients. Enables the productive interaction for clinical assessment, diagnosis, medication management, and therapy [6].
Tele-stroke
A network of audiovisual communication and computer systems providing the foundation for a collaborative, interprofessional care model focusing on acute stroke patients [7].
Tele-sonography
Combination of the use of ultrasound with telemedicine, allows for off-site expert interpretation as a solution to the major disadvantage of ultrasound, namely the skill required to interpret images [8].
1.
LeRouge C, Garfield MJ, Hevner AR, editors. Quality attributes in telemedicine video conferencing. Proceedings of the 35th Annual Hawaii International Conference on System Sciences; 2002: IEEE.
2.
Houston MS, Myers JD, Levens SP, McEvoy MT, Smith SA, Khandheria BK, et al., editors. Clinical consultations using store-and-forward telemedicine technology. Mayo Clinic Proceedings; 1999: Elsevier.
3.
Omboni S, Ferrari R. The role of telemedicine in hypertension management: focus on blood pressure telemonitoring. Current hypertension reports. 2015;17(4):21.
4.
Draper JV, Kaber DB, Usher JM. Telepresence. Human factors. 1998;40(3):354-75.
5.
Deldar K, Bahaadinbeigy K, Tara SM. Teleconsultation and Clinical Decision Making: a Systematic Review. Acta Inform Med. 2016;24(4):286-92.
6.
Adaji A, Fortney J. Telepsychiatry in Integrated Care Settings. Focus (Am Psychiatr Publ). 2017;15(3):257-63.
7.
Demaerschalk BM, Berg J, Chong BW, Gross H, Nystrom K, Adeoye O, et al. American Telemedicine Association: Telestroke Guidelines. Telemed J E Health. 2017;23(5):376-89.
8.
Marsh-Feiley G, Eadie L, Wilson P. Telesonography in emergency medicine: A systematic review. PloS one. 2018;13(5):e0194840.
Literature
go back to reference Lazarus, G, Permana AF, Nugroho SW, Audrey J, Wijaya DN, Widyahening IS (2020) Telestroke strategies to enhance acute stroke management in rural settings: A systematic review and meta-analysis. Brain Behav e01787. https://doi.org/10.1002/brb3.1787 Lazarus, G, Permana AF, Nugroho SW, Audrey J, Wijaya DN, Widyahening IS (2020) Telestroke strategies to enhance acute stroke management in rural settings: A systematic review and meta-analysis. Brain Behav e01787. https://​doi.​org/​10.​1002/​brb3.​1787
go back to reference Pak D, Pak K (2015) Effectiveness of telemedicine in acute/emergency care settings versus face to face patient care: A systematic literature review. J Med Internet Res 3: e14 (1-13) Pak D, Pak K (2015) Effectiveness of telemedicine in acute/emergency care settings versus face to face patient care: A systematic literature review. J Med Internet Res 3: e14 (1-13)
go back to reference Sun S, Lu SF, Rui H (2018) Does Telemedicine Improve Operational Efficiency? Evidence from New York Emergency Departments Sun S, Lu SF, Rui H (2018) Does Telemedicine Improve Operational Efficiency? Evidence from New York Emergency Departments
go back to reference Winburn AS, Brixey JJ, Langabeer J 2nd, Champagne-Langabeer T (2018) A systematic review of prehospital telehealth utilization. J Telemed Telecare 24: 473-81. 10.1177%2F1357633X17713140 Winburn AS, Brixey JJ, Langabeer J 2nd, Champagne-Langabeer T (2018) A systematic review of prehospital telehealth utilization. J Telemed Telecare 24: 473-81. 10.1177%2F1357633X17713140
Metadata
Title
Telemedicine in the emergency department: an overview of systematic reviews
Authors
Ali Sharifi Kia
Mouna Rafizadeh
Leila Shahmoradi
Publication date
27-01-2022
Publisher
Springer Berlin Heidelberg
Keyword
Telemedicine
Published in
Journal of Public Health / Issue 8/2023
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI
https://doi.org/10.1007/s10389-021-01684-x

Other articles of this Issue 8/2023

Journal of Public Health 8/2023 Go to the issue