As the field of telemedicine continues to grow, the mobile applications used to facilitate remote patient care has expanded with it. Many of the apps available in telemedicine are designed for use in the emergency department, but to date there has been little effort to measure the impact these digital tools have on patients and clinicians.
To address this information void, Marcia M. Ward, of the University of Iowa’s Department of Health Management and Policy, and her colleagues analyzed 38 empirical studies that looked at the role of telemedicine apps in emergency medicine and found that “Overwhelmingly, tele-emergency studies reported positive findings especially in terms of technical quality and user satisfaction. There were also positive findings reported for clinical processes and outcomes, through- put, and disposition, but the rigor of studies using these measures was limited.”
Ward et al looked at apps in three broad categories: general ER use, minor treatment clinics, and special patient populations, which included patients with stroke, trauma, cardiac problems, and other specialized care. (Although the authors provide a reference list of all 38 studies that they drew on for the systematic review, they did not list the ER apps by name.)
About half of the studies in each of the three groups dealt with the technical quality of the apps, and concluded that physicians and nurses were generally satisfied with image and teleconferencing quality. A few clinicians reported problems with data transmission and networking, including network coverage and the amount of memory available.
Among the apps that involved general ER use, “physicians found the tele-emergency applications useful for remote consultation and sensitive in detecting findings (normal or abnormal).” In the apps designed for use in special patient populations, they were found to be “clinically effective across diverse medical conditions.” The telemedicine apps allowed for timely therapy for cardiology and pulmonary patients, for example, and quick intervention for psychiatric patients. And in remote stroke management, one of the most time-sensitive areas of ER care, Ward et al reported “Positive clinical outcomes were specifically emphasized in the five studies involving stroke patients in rural and community settings, which indicated that tele-emergency services facilitated the safe and timely administration of therapy to patients in rural areas and improved care as perceived by physicians.”
