Mark X Cicero1, Barbara Walsh2, Yauheni Solad3, Travis Whitfill1, Geno Paesano1, Kristin Kim1, Carl R Baum1, David C Cone4. 1. 1Yale University School of MedicineDepartment of Pediatrics,Section of Pediatric Emergency Medicine,New Haven, ConnecticutUSA. 2. 2University of Massachusetts School of Medicine,Department of Pediatrics,Section of Pediatric Emergency Medicine,Worcester, MassachusettsUSA. 3. 3Yale University School of MedicineDepartment of Medical Informatics,New Haven, ConnecticutUSA. 4. 4Yale University School of MedicineDepartment of Emergency Medicine,Section of Emergency Medical Services,New Haven, ConnecticutUSA.
Abstract
INTRODUCTION: Disasters are high-stakes, low-frequency events. Telemedicine may offer a useful adjunct for paramedics performing disaster triage. The objective of this study was to determine the feasibility of telemedicine in disaster triage, and to determine whether telemedicine has an effect on the accuracy of triage or the time needed to perform triage. METHODS: This is a feasibility study in which an intervention team of two paramedics used the mobile device Google Glass (Google Inc; Mountain View, California USA) to communicate with an off-site physician disaster expert. The paramedic team triaged simulated disaster victims at the triennial drill of a commercial airport. The simulated victims had preassigned expected triage levels. The physician had an audio-video interface with the paramedic team and was able to observe the victims remotely. A control team of two paramedics performed disaster triage in the usual fashion. Both teams used the SMART Triage System (TSG Associates LLP; Halifax, England), which assigns patients into Red, Yellow, Green, and Black triage categories. The paramedics were video recorded, and their time required to triage was logged. It was determined whether the intervention team and the control team varied regarding accuracy of triage. Finally, the amount of time the intervention team needed to triage patients when telemedicine was used was compared to when that team did not use telemedicine. RESULTS: The two teams triaged the same 20 patients. There was no significant difference between the two groups in overall triage accuracy (85.7% for the intervention group vs 75.9% for the control group; P = .39). Two patients were triaged with telemedicine. For the intervention group, there was a significant difference in time to triage patients with telemedicine versus those without telemedicine (35.5 seconds; 95% CI, 72.5-143.5 vs 18.5 seconds; 95% CI, 13.4-23.6; P = .041). CONCLUSION: There was no increase in triage accuracy when paramedics evaluating disaster victims used telemedicine, and telemedicine required more time than conventional triage. There are a number of obstacles to available technology that, if overcome, might improve the utility of telemedicine in disaster response.
INTRODUCTION: Disasters are high-stakes, low-frequency events. Telemedicine may offer a useful adjunct for paramedics performing disaster triage. The objective of this study was to determine the feasibility of telemedicine in disaster triage, and to determine whether telemedicine has an effect on the accuracy of triage or the time needed to perform triage. METHODS: This is a feasibility study in which an intervention team of two paramedics used the mobile device Google Glass (Google Inc; Mountain View, California USA) to communicate with an off-site physician disaster expert. The paramedic team triaged simulated disaster victims at the triennial drill of a commercial airport. The simulated victims had preassigned expected triage levels. The physician had an audio-video interface with the paramedic team and was able to observe the victims remotely. A control team of two paramedics performed disaster triage in the usual fashion. Both teams used the SMART Triage System (TSG Associates LLP; Halifax, England), which assigns patients into Red, Yellow, Green, and Black triage categories. The paramedics were video recorded, and their time required to triage was logged. It was determined whether the intervention team and the control team varied regarding accuracy of triage. Finally, the amount of time the intervention team needed to triage patients when telemedicine was used was compared to when that team did not use telemedicine. RESULTS: The two teams triaged the same 20 patients. There was no significant difference between the two groups in overall triage accuracy (85.7% for the intervention group vs 75.9% for the control group; P = .39). Two patients were triaged with telemedicine. For the intervention group, there was a significant difference in time to triage patients with telemedicine versus those without telemedicine (35.5 seconds; 95% CI, 72.5-143.5 vs 18.5 seconds; 95% CI, 13.4-23.6; P = .041). CONCLUSION: There was no increase in triage accuracy when paramedics evaluating disaster victims used telemedicine, and telemedicine required more time than conventional triage. There are a number of obstacles to available technology that, if overcome, might improve the utility of telemedicine in disaster response.
Entities:
Keywords:
HIPAA Health Insurance Portability and Accountability Act; OS operating system; triage
Authors: John Broach; Alexander Hart; Matthew Griswold; Jeffrey Lai; Edward W Boyer; Aaron B Skolnik; Peter R Chai Journal: Proc Annu Hawaii Int Conf Syst Sci Date: 2018-01-03
Authors: Kori S Zachrison; Emily M Hayden; Krislyn M Boggs; Tehnaz P Boyle; Jingya Gao; Margaret E Samuels-Kalow; James P Marcin; Carlos A Camargo Journal: J Med Internet Res Date: 2022-06-20 Impact factor: 7.076
Authors: Sandra Odenheimer; Deepika Goyal; Veena Goel Jones; Ruth Rosenblum; Lam Ho; Albert S Chan Journal: J Med Internet Res Date: 2018-06-21 Impact factor: 5.428
Authors: Shiyao Wang; Michael Parsons; Jordan Stone-McLean; Peter Rogers; Sarah Boyd; Kristopher Hoover; Oscar Meruvia-Pastor; Minglun Gong; Andrew Smith Journal: Sensors (Basel) Date: 2017-10-10 Impact factor: 3.576