TELEmedicine as an intervention for sepsis in emergency departments: a multicenter, comparative effectiveness study (TELEvISED Study)

Author:

Mohr Nicholas M123ORCID,Harland Karisa K1,Okoro Uche E1,Fuller Brian M45,Campbell Kalyn16,Swanson Morgan B13,Simpson Stephen Q78,Parker Edith A9,Mack Luke J1011,Bell Amanda10,DeJong Katie10,Faine Brett11213,Zepeski Anne113,Mueller Keith14,Chrischilles Elizabeth3,Carpenter Christopher R5,Jones Michael P15,Ward Marcia M14

Affiliation:

1. Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA

2. Division of Critical Care, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA

3. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA

4. Division of Critical Care, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA

5. Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA

6. Department of Surgery, Hennepin County Medical Center, Minneapolis, MN 55415, USA

7. Department of Pulmonary, Critical Care, & Sleep Medicine, University of Kansas, Kansas City, KS 66160, USA

8. Biomedical Advanced Research & Development Authority, US Department of Health & Human Services, Washington, DC 20201, USA

9. Department of Community & Behavioral Health, University of Iowa College of Public Health, Iowa City, IA 52242, USA

10. Avera eCARE, Sioux Falls, SD 57104, USA

11. Department of Family Medicine, University of South Dakota School of Medicine, Sioux Falls, SD 57105, USA

12. Department of Pharmacy Practice & Science, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA

13. Department of Pharmaceutical Care, University of Iowa Hospitals & Clinics, Department of Health Management & Policy, Iowa City, IA 52242, USA

14. Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA 52242, USA

15. Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA 52242, USA

Abstract

Sepsis is a life-threatening infection that affects over 1.7 million Americans annually. Low-volume rural hospitals have worse sepsis outcomes, and emergency department (ED)-based telemedicine (tele-ED) has been one promising strategy for improving rural sepsis care. The objective of this study is to evaluate the impact of tele-ED consultation on sepsis care and outcomes in rural ED patients. The TELEvISED study is a multicenter (n = 25) retrospective propensity-matched comparative effectiveness study of tele-ED care for rural sepsis patients in a mature tele-ED network. Telemedicine-exposed patients will be matched with non telemedicine patients using a propensity score to predict tele-ED use. The primary outcome is 28-day hospital free days, and secondary outcomes include adherence with guidelines, mortality and organ failure. ClinicalTrials.gov: NCT04441944 .

Publisher

Future Medicine Ltd

Subject

Health Policy

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