Using telemedicine to avoid transfer of rural emergency department patients

Access to emergency treatment ill rural areas call often mean the differenc e between life and death. Telemedicine technologies have the potential of p roviding earlier diagnosis and intervention, of saving lives and of avoidin g unnecessary transfers from rural hospital emergency departments to urban hospitals. This study examined the hypothetical impact of telemedicine serv ices on patients served by the emergency departments of two rural Missouri hospitals and the potential financial impact on the affected hospitals. Of the 246 patients transferred to the hub hospital from the two facilities du ring 1996, 161 medical records (65.4) percent) were analyzed. Using a conse rvative approach, only 12 of these cases were identified as potentially avo idable transfers with the use of telemedicine. Of these 12, 5 were admitted to the hub after transfer. In addition to this conservative estimate of av oidable transfers based on current availability of resources in the rural h ospitals, two more aggressive scenarios were developed, based on an assumpt ion of increased services availability in the rural hospitals. Economic mul tipliers were used to estimate the financial impacts on communities in each scenario. This evaluation study demonstrates the potential value of teleme dicine use in rural emergency departments to patients, rural hospitals and rural communities.