Rural hospitals using telemedicine services reduce the time between patients entering the emergency department to receiving physician care by six minutes, according to a new study led by University of Iowa researchers.

The research team, headed by Nicholas Mohr, UI associate professor of emergency medicine and anesthesia, measured the impact of emergency department (ED)-based telemedicine services on timeliness of care in rural hospitals. The study looked at data collected from 14 hospitals in Iowa, Kansas, Nebraska, North Dakota, and South Dakota that subscribe to telemedicine services from a single ED-based telemedicine provider. The team matched 2,857 emergency department cases that used telemedicine services with non-telemedicine controls.

The results, published online Jan. 2 in Telemedicine and e-Health, showed that telemedicine decreased door-to-provider time by six minutes. This provider could be either a local provider physically assessing the patient or a telemedicine provider—whoever was available first. The first provider seeing the patient was a telemedicine provider in 41.7 percent of telemedicine encounters, and in these cases, telemedicine was 14.7 minutes earlier than local providers.

The researchers also noted that among patients who were transferred to other hospitals, ED length-of-stay at the first hospital was shorter in patients who had telemedicine consulted. The authors suggest that this reduced time may be due to remotely located staff completing administrative and charting tasks, allowing local staff to concentrate on patient care.

The study team included Tracy Young, Karisa Harland, and Marcia Ward from the University of Iowa; and Brian Skow, Amy Wittrock, and Amanda Bell from Avera eCare.

The project was supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services and the analysis was conducted by the Rural Telehealth Research Center at the University of Iowa.

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