Videotelephony-assisted medical direction to improve emergency medical service

Am J Emerg Med. 2020 Apr;38(4):754-758. doi: 10.1016/j.ajem.2019.06.023. Epub 2019 Jun 14.

Abstract

Introduction: In South Korea, on-line medical direction using voice calls has been implemented to improve the quality of the emergency medical system. However, in the same, short time span, video will be able to convey more information than by voice. The purpose of this study is to find out if videotelephony-assisted medical direction (VAMD) can change the intervention of the emergency medical technician compared to using conventional voice calls.

Methods: We conducted a prospective study of 312 patients with online medical direction from November 2017 to November 2018. We assisted patients with direct medical direction using conventional voice calls from October to November 2017, and then VAMD was implemented from October to November 2018.

Results: From the total number of conventional voice calls, 131 were used for this study, and of the total number of VAMD interventions, 181 were included. There were differences between conventional voice call and VAMD interventions in such types of medical direction as hospital selection (7.6% vs. 36.6%), ECG interpretation (0% vs. 3.4%), and advice on medical techniques (0% vs. 25.1%). The effectiveness of VAMD by survey is greater compared to conventional direct medical direction using voice calls (median value, 3.0 vs. 1.5).

Conclusions: The number of instances of medical direction for some interventions, such as interpretation of ECG and advice on medical techniques that did not perform well in conventional voice calls, increased in VAMD. VAMD may play an important role in the prehospital emergency care.

Keywords: Emergency medical service; Medical direction; On-line medical direction; Prehospital emergency care; Videotelephony.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Decision Support Techniques*
  • Emergency Medicine / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Republic of Korea
  • Statistics, Nonparametric
  • Telemedicine / methods
  • Telemedicine / standards*
  • Telemedicine / trends