An Assessment of the Potential Benefits of Video Consultation in the Emergency Department: Mixed Methods Study

Jane Turner; Malcolm Clarke; Grizelda George; Russell Wynn Jones; Rick Pullinger; Rajesh Kharbanda; James Kennedy; Linda Hands

doi:10.2196/36081

An Assessment of the Potential Benefits of Video Consultation in the Emergency Department: Mixed Methods Study

Interact J Med Res. 2022 Sep 15;11(2):e36081. doi: 10.2196/36081.

Authors

Affiliations

¹ Nuffield Department of Surgical Science, University of Oxford, Oxford, United Kingdom.
² Department of Electronic Engineering, Maynooth International Engineering College, Fuzhou, China.
³ Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom.
⁴ Chorleywood Health Centre, Chorleywood, United Kingdom.

^# Contributed equally.

PMID: 36107488
PMCID: PMC9523531
DOI: 10.2196/36081

Abstract

Background: District general hospital emergency departments may refer patients to a tertiary center depending on the information available to a generalist clinician in discussion with a specialist team. If there is uncertainty, the lowest-risk strategy is often to transfer the patient. Video consultation allowing the specialist team to see and talk to the patient and local clinician while still in the emergency department could improve decision-making for patient transfer.

Objective: The aim of this study is to assess the potential benefit of real-time video consultation between remote specialists and emergency department patients and clinicians across all specialties.

Methods: Detailed patient data were collected prospectively for 6 months (between January 16, 2012, and July 15, 2012) on all patients presenting to a district general hospital emergency department who required input from a specialist team at the nearest tertiary care center. These patients were discussed retrospectively with the specialist teams to determine whether videoconferencing could have benefited their management. The logistics for the use of videoconferencing were explored.

Results: A total of 18,799 patients were seen in the emergency department during the study period. Among the 18,799 patients, 413 referrals (2.2%) were made to the tertiary center specialist teams. A review of the patients transferred indicated that 193 (46.7%) of the 413 patients who were referred might have benefited from video consultation (193/18,799, 1% of all patients). If the specialist team could be accessed via videoconferencing only while a senior member was available in the hospital (8:00 AM-10:00 PM), then a maximum of 5 patients per week across all specialties would use the equipment. If 24-hour specialist access was available, this would increase to 7 patients per week.

Conclusions: In regions where there is direct transportation of patients by ambulance to specialist centers and there is a regional picture archiving and communication system in place, video consultation between emergency department patients and specialists has limited potential to improve patient management.

Keywords: benefit; eHealth; emergency; emergency medicine; health service research; patient management; remote; specialist; telehealth; telemedicine; video conference; video conferencing; video consultation; videoconferencing.

©Jane Turner, Malcolm Clarke, Grizelda George, Russell Wynn Jones, Rick Pullinger, Rajesh Kharbanda, James Kennedy, Linda Hands. Originally published in the Interactive Journal of Medical Research (https://www.i-jmr.org/), 15.09.2022.