A telemedicine model for emergency care in a short-term correctional facility

The primary objectives of this research were to determine the effectiveness of a personal computer-based telemedicine system for semi- and nonurgent c omplaints at a short-term correctional facility and to evaluate the system as a potential model for providing emergency care to remote locations. We p erformed a retrospective review of medical records of patients referred to the emergency department in person or via telemedicine during a 12-month pe riod. The data included system utilization, chief complaints, physical exam ination, diagnostic testing, disposition, and outcomes in patients evaluate d via telemedicine. Also identified were nursing diagnostic and procedure s kills associated with successful evaluation via telemedicine. A total of 53 0 emergency care records were reviewed with 126 telemedicine consultations performed. Eighty-one of 126 (64%) telemedicine patients remained at the fa cility following consultation with the remaining 45 (36%) being transported to the emergency department. Rates of return to the emergency department w ithin 7 days following consultation were comparable, patient acceptance and satisfaction was high, and there were no untoward outcomes in the group. A verage total time of telemedicine consultation was 30 minutes versus a 2-ho ur and 45-minutes turnaround time for an emergency department evaluation. A variety of emergency complaints were managed effectively using relatively low-cost computer-based telemedicine technology, thereby eliminating the ne ed for transportation of the patient to the emergency department. This syst em provides an emergency physician-nurse model for conduction limited emerg ency care in remote settings.