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Health Aff (Millwood). 2014 Feb;33(2):228-34. doi: 10.1377/hlthaff.2013.1016.

Lessons from tele-emergency: improving care quality and health outcomes by expanding support for rural care systems.

Abstract

Tele-emergency services provide immediate and synchronous audio/video connections, most commonly between rural low-volume hospitals and an urban "hub" emergency department. We performed a systematic literature review to identify tele-emergency models and outcomes. We then studied a large tele-emergency service in the upper Midwest. We sent a user survey to all seventy-one hospitals that used the service and received 292 replies. We also conducted telephone interviews and site visits with ninety clinicians and administrators at twenty-nine of these hospitals. Participants reported that tele-emergency improves clinical quality, expands the care team, increases resources during critical events, shortens time to care, improves care coordination, promotes patient-centered care, improves the recruitment of family physicians, and stabilizes the rural hospital patient base. However, inconsistent reimbursement policy, cross-state licensing barriers, and other regulations hinder tele-emergency implementation. New value-based payment systems have the potential to reduce these barriers and accelerate tele-emergency expansion.

KEYWORDS:

Access To Care; Information Technology; Organization and Delivery of Care; Quality Of Care; Rural Health Care

PMID:
24493765
DOI:
10.1377/hlthaff.2013.1016
[Indexed for MEDLINE]

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