Telemedicine in the emergency department: a randomized controlled trial

Emergency physicians and nurses were trained in telemedicine techniques in two emergency departments, one rural (low volume) and one suburban (high vo lume). Fifteen patient complaints were selected as appropriate for the stud y. Of 122 patients who met the inclusion criteria, 104 (85%) consented to p articipate. They were randomized to control and experimental groups. The su burban emergency physician diagnosed and treated the control patients. Expe rimental patients presenting to the high-volume emergency department were e valuated and treated by the telemedicine nurse in person and the rural emer gency physician via the telemedicine link. Immediately before discharge all telemedicine patients were re-evaluated by the suburban emergency physicia n. Data collected on each patient included: diagnosis; treatment; 72 h retu rn visits; need for additional care; and satisfaction of patient, physician s and nurses. There were no significant differences (P> 0.05) for occurrenc e of 72 h return visits, need for additional care or overall patient satisf action. The average patient throughput time (from admission to discharge) w as 106 min for the telemedicine group and 117 min for the control group. Te lemedicine was a satisfactory technique for the chosen group of patients in the emergency department and was acceptable to the participants.