Resource availability in US emergency departments (EDs) varies substantially, with major disparities in access. Growing regionalization has contributed to decreased consultant availability in many smaller or rural EDs. Telehealth could mitigate this by enabling these EDs to connect with expertise when needed.
Telehealth is feasible and effective for improving clinical care in EDs. Telehealth may also enable fewer patient transfers and improved coordination of care during transfer. The value of telehealth has been well established in stroke care delivery, i.e., telestroke. In contrast, telehealth in pediatric emergency medicine remains underutilized. The role for telehealth and the extent of update for these applications is unclear. Data on whether or not each ED used telehealth was collected on the 2016 National ED-Inventory survey. Since then, we have continued to assess ED telehealth use annually through the NEDI-USA survey.
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Select telehealth publications:
- Zachrison KS, Boggs KM, Hayden E, Espinola JA, Camargo CA Jr. A national survey of telemedicine use by US emergency departments. J Telemed Telecare 2019; in press. PMID: 30558518
- Zachrison KS, Boggs KM, Hayden EM, Cash RE, Espinola JA, Samuels-Kalow ME, Sullivan AF, Mehrotra A, Camargo CA Jr. Factors associated with emergency department adoption of telemedicine: 2014-2018. J Am Coll Emerg Physicians Open 2020; 1: 1304-1311. PMID: 33392537
- Zachrison KS, Boggs KM, Cash RE, Burton KR, Espinola JA, Hayden EM, Sauser JP, Mehrotra A, Camargo CA Jr. Are state telemedicine parity laws associated with greater use of telemedicine in the emergency department? J Am Coll Emerg Physicians Open 2021; 2: e212359. PMID: 33491006
Ongoing Telehealth Projects
In Spring 2021, EMNet launched a survey to all 189 New England EDs to investigate their current disaster response capabilities, their willingness to use telehealth for disaster response, and barriers to using telehealth for disaster response. The responses to this survey will inform next steps in implementing a regional disaster response telehealth system. This study is funded by the HHS Office of the Assistant Secretary for Preparedness and Response (PI: Paul Biddinger).
Please contact Dr. Tehnaz Boyle if you would like additional details.
EMNet is collaborating with the University of Iowa on a study to investigate the impact of rural telehealth on long-term sepsis health care costs and outcomes through decreasing organ failure, hospital length-of-stay, and readmissions. This study is funded by HRSA (PI: Nicholas Mohr).
Please contact Krislyn Boggs if you would like additional details.
We matched stroke patients at 767 hospitals with telestroke with similar patients at hospitals without telestroke to understand the impact of telestroke on where patients get care, likelihood of dying, disability, and the experience of front-line physicians and nurses. This study is funded by the NIH (PI: Ateev Mehrotra).
Please contact Dr. Kori Zachrison if you would like additional details.
Past Telehealth Projects
EMNet completed a study to investigate the usage of telehealth for psychiatry, or telepsychiatry, in 235 U.S. EDs in 2017 and 2019. Please contact Rain Freeman if you would like additional details.
Freeman RE, Boggs KM, Zachrison KS, Freid RD, Sullivan AF, Espinola JA, Camargo CA Jr. National study of telepsychiatry use in U.S. emergency departments. Psychiatr Serv 2020; 71: 540-546. PMID: 32019430
EMNet completed a study to investigate the usage of telehealth to evaluate pediatric patients in 237 U.S. EDs in 2017 and 2019. Please contact Krislyn Boggs if you would like additional details.
Brova M, Boggs KM, Zachrison KS, Freid RD, Sullivan AF, Espinola JA, Boyle TP, Camargo CA Jr. Pediatric telemedicine use in U.S. emergency departments. Acad Emerg Med 2018; 25: 1427-1432. PMID: 30307078
In 2017-2018, EMNet completed a study to investigate barriers to telehealth use among 453 rural EDs that reported that they do not receive telehealth. Among 453 additional EDs that do receive telehealth, we investigated the utilization of telehealth for transfer coordination, stroke, and pediatrics. A survey collecting this information, as well as other information about ED characteristics was mailed to each ED.
This study was funded by the Emergency Medicine Foundation. Please contact Dr. Kori Zachrison if you would like additional details.
1. Zachrison KS, Boggs KM, Hayden EM, Espinola JA, Camargo CA Jr. Understanding barriers to telemedicine implementation in rural emergency departments. Ann Emerg Med 2020; 75: 392-399. PMID: 31474481
2. Hayden EM, Boggs KM, Espinola JA, Camargo CA Jr, Zachrison KS. Telemedicine facilitation of transfer coordination from emergency departments. Ann Emerg Med 2020; 76: 602-608. PMID: 32534835