Disposition of patients utilising the virtual emergency department service in southeast region of Melbourne (SERVED‐1)

Author:

Sri‐Ganeshan Muhuntha12ORCID,Mitra Biswadev12ORCID,Soldatos Georgia134,Howard Maddi5,Goldie Neil5,McGee Fergus6,Nehme Ziad178,Underhill Andrew2,O'Reilly Gerard M12ORCID,Cameron Peter A12ORCID,

Affiliation:

1. School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia

2. Emergency and Trauma Centre The Alfred Hospital Melbourne Victoria Australia

3. Diabetes and Vascular Medicine Unit Monash Health Melbourne Victoria Australia

4. School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Victoria Australia

5. Emergency Department Monash Health Melbourne Victoria Australia

6. Community, Integrated and Ambulatory Care Peninsula Health Melbourne Victoria Australia

7. Centre for Research and Evaluation Ambulance Victoria Melbourne Victoria Australia

8. Department of Paramedicine Monash University Melbourne Victoria Australia

Abstract

AbstractObjectiveSupported by the state government, three health networks partnered to initiate a virtual ED (VED), as part of a broader roll‐out of emergency telehealth services in Victoria. The aim of the present study (Southeast Region Virtual Emergency Department‐1 [SERVED‐1]) was to report the initial 5‐month experience and included all patients assessed through the service over the first 5 months (1 February 2022 to 30 June 2022).MethodsVED consults occurred after referral from paramedics in the pre‐hospital setting. Electronic medical records were retrospectively reviewed for demographic, presenting complaint and outcome data. The primary outcome was the count of VED consultations. The secondary outcome was the proportion of patients where physical ED attendance was avoided within 72 h. The proportion of physical ED attendances avoided sub‐grouped by primary presenting complaints were reported.ResultsThere were 1748 patients who had a VED consultation, of which 1261 (72.1%; 95% confidence interval [CI] 70.0–74.2) patients had physical presentation to an ED avoided in the 72 h following the consult. There was a significant increase in consultations over the 5‐month period (incidence rate ratio 1.27; 95% CI 1.23–1.31, P < 0.001) that was consistent in the three health services. The most common presenting complaints were COVID‐19 and shortness of breath, and physical presentation was avoided most often among younger patients and those with COVID‐19.ConclusionsInitial experience demonstrated a significant increase in adoption of the service and an overall avoidance of physical ED attendance by a majority of patients. These results support ongoing VED consultations, complemented by follow up and health economic evaluations.

Publisher

Wiley

Subject

Emergency Medicine

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