Effectiveness of telemedicine in acute / emergency care settings versus face to face patient care: A systematic literature review

The rapid development of technologies relating to telemedicine has brought with it new opportunities and potential particularly for use in time critical settings such as emergency care. It is also thought that telemedicine may help prevent attendance for minor illness or injury to major hospital emergency departments. We reviewed the evidence for telemedicine based approaches to emergency and acute healthcare settings in comparison to face to face patient care. Searches were performed in MEDLINE, EMBASE, PubMed and the Cochrane Database. In total, seven studies involving 958 patients with an acute or emergency medical presentation were identified. The quality of included trials was assessed using the Critical Appraisal Skills Programme (CASP) tool. Outcome data were pooled under four headings: time from symptom onset to consultation, patient satisfaction, mean duration of consultation and accuracy of diagnosis. During this review no results were found for a specific comparison between patient journey time to main unit and standard treatment intervention compared to telemedicine administered at a satellite clinic or facility. Further evidence is needed regarding the efficacy of telemedicine with regard to unnecessary patient recall and the possible difficulty it presents in clinician agreement rates within diagnostic and patient management decision making. In addition greater focus could be given to the patient and practitioner satisfaction rates as well as further examination of possible time saving in response rates and implementation of appropriate treatment with the use of telemedicine.