Consultation times in emergency telemedicine using realtime videoconferencing

Abstract

We reviewed 2135 consecutive emergency teleconsultations, which were received at an academic emergency department from state correctional facilities. During the 52-week study period, an average of 5.8 video-consultations per day were performed. A total of 1522 consultations (71%) had complete start and end consultation times, and were included in the analysis. Of these, 923 were managed primarily by emergency medicine residents and physician assistants, while the remaining 599 were managed by attending physicians alone. Following consultation, the disposition of the patients included 940 who were transported to the emergency department, 351 who were discharged to the general facility population and 193 who were admitted to the local infirmary. Overall, 38% of patients avoided a journey to the emergency department. The average consultation time was 17 min (95% confidence interval [CI], 10–24). The average consultation time for residents and physician assistants was 16 min (95% CI, 8–24) and it was 19 min (95% CI, 11–27) for attending physicians. Consultation time for patients not transported to the emergency room was 21 min (95% CI, 13–29), while for patients transferred to an emergency department, consultation time was 15 min (95% CI, 9–21). These results may assist in planning the workforce requirements for emergency department-based telemedicine services.