Implementation Strategy and Systemic Effects of Routine Telemedical Care in Prehospital Emergency Medicine

Completed

• Conditions: Emergency Medical Service Missions; Telemedicine Usage; Teleconsultation Usage

• Registration Number: NCT04127565
• Lead Sponsor: RWTH Aachen University

Brief Summary

In two research projects a comprehensive prehospital telemedicine system was developed and general feasibility as well as impact on guideline adherence were evaluated. These results allowed stepwise implementation into medical routine care.

All steps and milestones from the research idea to implementation were analyzed and evaluated descriptively in this study. Using a pre-post intervention analysis the systemic effects of the implementation on change in emergency medical resource utilization were analyzed.

Detailed Description

In two interdisciplinary research projects a comprehensive prehospital telemedicine system was developed and general feasibility as well as impact on guideline adherence were evaluated. Feasibility and general safety were demonstrated. These results allowed stepwise implementation into medical routine care during a one year phase. During implementation positive effects on guideline adherence were found. Despite positive results there are many barriers that prevent implementation of research projects into routine medical care. Therefore, the current study evaluated and interpreted all steps and milestones from the research idea to implementation and evaluated them descriptively. Using a pre-post intervention analysis the systemic effects of the implementation on change in emergency medical resource utilization were analyzed. Resource utilization of physician staffed emergency medical service units was compared between a pre-implementation period (12 months, April 2013 - March 2014) and a post-implementation period (12 months, April 2015 - March 2016). During the pre-implementation period only standard care was available.

Inclusion criteria: All emergency medical service (EMS) missions in both periods.

Data sources: Electronic health records of the EMS missions (data pseudonymity) and database of the regional EMS dispatch center.

Study Timeline

• Study Start: 2013-04-01
• Primary Completion: 2016-03-31
• Study Completion: 2016-03-31
• Status Verified: 2019-10
• Study First Submitted: 2019-10-04
• Study First Submitted QC: 2019-10-12
• Last Update Submitted: 2019-10-12
• Study First Posted: 2019-10-15
• Last Update Posted: 2019-10-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 51649

Inclusion Criteria

All patients treated by emergency medical service during the pre- and post-implementation period.

Post-implementation period: Patients had to give verbal consent prior to teleconsultation.

Read More

Exclusion Criteria

Pre-implementation period: none Post-implementation period: Patients who refused teleconsultation.

Read More

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Change in usage of physician staffed EMS units	Comparison between 1 year pre-implementation and 1 year post-implementation period.	Change in usage of physician staffed EMS units (ground based and helicopter based). Comparison between the pre- and post-implementation period.

Secondary Outcome Measures

Name	Time	Method
Usage of telemedical support in the post-implementation period	Through study completion in the post-implementation period (1 year)	Number of ambulance calls using telemedical support
Provided medications during teleconsultation	Through study completion in the post-implementation period (1 year)	Number of delegated medications including opioids in the post-implementation phase