Emergency physicians' roles in a clinical telemedicine network

Study objective: To study the roles emergency physicians have in a clinical telemedicine network. Methods: A descriptive analysis of telemedicine consultations conducted by emergency physicians at 1 year of operation of a private clinical telemedicine program. Results: From February 1, 1995, to February 1, 1996, 190 clinical telemedicine consultations were completed. Emergency medicine constituted the most common specialty consulted, accounting for 45 (24%) of the consultations. All consultations were one-time transmissions and interactions. They ranked as follows: trauma or orthopedic care, 33 (73%); adult medical problems, 6 (13%); and pediatric medical problems, 6 (13%), Of the emergency medicine teleconsultations, 39 (87%) were categorized as emergency (completed immediately). Of the emergency medicine consultations completed, 24 (53%) patients remained in the rural community, and 21 (47%) were transferred to the tertiary care facility for additional care. The primary peripheral used for emergency medicine teleconsultations was a one-chip document camera. Forty-three (96%) of the emergency medicine teleconsultations involved radiograph interpretations. The most common radiographs reviewed were of the arm, 14 (33%); leg, 10 (23%); and cervical spine, 7 (16%). There was one minor radiograph interpretation discrepancy. Of the emergency medicine teleconsultations, 65% occurred between 7 PM and 8 AM. Of emergency medicine teleconsultations, 24% were completed on Saturdays and Sundays, with 26% of consultations being completed on Fridays. All emergency physicians involved in telemedicine consultations were surveyed concurrently for satisfaction, future use, and recommendations for improvement. Conclusion: The technology afforded by telemedicine allows emergency physicians to participate in telemedicine consultations. Emergency physicians should consider using clinical telemedicine in their practice.