Implementation Strategy and Systemic Effects of Routine Telemedical Care in Prehospital Emergency Medicine

RWTH Aachen University

Status: Completed

Conditions: Telemedicine Usage; Teleconsultation Usage; Emergency Medical Service Missions

Study type: Observational

Funder types: Other

Identifiers

NCT04127565

TNA2019-01

Details and patient eligibility

About

In two research projects a comprehensive prehospital telemedicine system was developed and general feasibility as well as impact on guideline adherence were evaluated. These results allowed stepwise implementation into medical routine care.

All steps and milestones from the research idea to implementation were analyzed and evaluated descriptively in this study. Using a pre-post intervention analysis the systemic effects of the implementation on change in emergency medical resource utilization were analyzed.

Full description

In two interdisciplinary research projects a comprehensive prehospital telemedicine system was developed and general feasibility as well as impact on guideline adherence were evaluated. Feasibility and general safety were demonstrated. These results allowed stepwise implementation into medical routine care during a one year phase. During implementation positive effects on guideline adherence were found. Despite positive results there are many barriers that prevent implementation of research projects into routine medical care. Therefore, the current study evaluated and interpreted all steps and milestones from the research idea to implementation and evaluated them descriptively. Using a pre-post intervention analysis the systemic effects of the implementation on change in emergency medical resource utilization were analyzed. Resource utilization of physician staffed emergency medical service units was compared between a pre-implementation period (12 months, April 2013 - March 2014) and a post-implementation period (12 months, April 2015 - March 2016). During the pre-implementation period only standard care was available.

Inclusion criteria: All emergency medical service (EMS) missions in both periods.

Data sources: Electronic health records of the EMS missions (data pseudonymity) and database of the regional EMS dispatch center.

Enrollment: 51,649 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

All patients treated by emergency medical service during the pre- and post-implementation period.

Post-implementation period: Patients had to give verbal consent prior to teleconsultation.

Exclusion criteria

Pre-implementation period: none Post-implementation period: Patients who refused teleconsultation.

Trial design

51,649 participants in 2 patient groups

Pre-implementation period

Description:

All emergency medical service missions (EMS) in the city of Aachen (Germany) from April 2013 to March 2014. Analysis of all ambulance calls and fraction of calls with support by an physician-staffed EMS unit, help of neighboring EMS units and helicopter emergency medical service units.

Post-implementation period

Description:

All emergency medical service missions (EMS) in the city of Aachen (Germany) from April 2015 to March 2016. Analysis of all ambulance calls and fraction of calls with support by an physician-staffed EMS unit, help of neighboring EMS units and helicopter emergency medical service units. Additionally analysis of all ambulance calls with telemedical support.