Use of telehealth for patients referred to a retrieval service: timing, destination, mode of transport, escort level and patient care

Abstract

We examined the utility of telehealth in assisting the decision-making processes of aeromedical coordinators, with particular focus on the timing, destination, mode of transport and escort level. Medical coordinators from the Northern Operations site of the Queensland emergency retrieval service were asked to complete a survey form about the changes that telehealth made to their retrieval decision-making process. Information was collected in six areas: diagnosis, severity, priority, crew, mode of transport and destination. During a 12-month period, there were 403 emergency referrals from the five participating sites. There were 136 eligible patient referrals for analysis, of which 90 did not have teleconsultations performed; the most common reasons were that the medical coordinator was too busy with other work or the new procedure was forgotten ( n = 39, 43%). The remaining 46 patients had a teleconsultation during the trial and 44 data sheets were available for analysis. In 21 cases some component of the decision-making process was altered by the use of telehealth, with decisions being significantly altered in nine cases. Most alterations were for severity of patient condition, then diagnosis and priority of transfer. The use of telehealth was thought to be beneficial in confirming the original decision in 30 cases. Telehealth was not of assistance in seven cases. Telehealth appears to assist in accurate decision-making during the medical coordination of aeromedical retrievals.