Emergency Department Physician Telemedical Triage

Background:Telemedical physician triage (TPT) is a potential application of telemedicine in the emergency department (ED). We report the technical success, patient satisfaction, and effect on ED throughput metrics (length of stay [LOS] and time to physician evaluation [TPE]) of TPT performed on a mobile platform.Materials and Methods:Patients underwent standard nursing triage with or without TPT. Technical success is reported as raw data. Patient satisfaction is reported as raw data +/- standard deviation on a 5-point (low-to-high) scale. LOS and TPE are reported as mean +/- SD [95% CI] values. Statistical analyses of LOS and TPE are via two-sample t test.Results:One hundred six patients were registered during intervention periods, and TPT was completed in 36 (34%). One hundred ninety-six patients were registered during control periods. The technical success rate was 95%. Average patient satisfaction was 4.7 on a 5-point scale. The primary analysis (106 patients) showed no change in LOS (266 +/- 101 [244-288] min versus 258 +/- 172 [234-282] min) but a trend toward improved TPE with TPT (35 +/- 28 [29-41] min versus 42 +/- 31 [38-46] min) (p=0.052). A secondary analysis (36 patients) showed no change in LOS (273 +/- 125 [231-316] min versus 258 +/- 172 [234-282] min) but improved TPE with TPT (16 +/- 15 [11-21] min versus 42 +/- 31 [38-46] min) (p<0.0001).Conclusions:TPT in the ED on a mobile platform was technically successful, well accepted by patients, and associated with a decrease in TPE but not LOS.