Assessment of Telemedicine and Phone Consultation Effects on Rate of Hand Transfers to Trauma Centers and Specialty Services Referrals

Abstract

Background Telemedicine consultation can increase patients’ access to subspecialty care and decrease the number of unnecessary hospital transfers. In 2014, the Arkansas Hand Trauma Telemedicine Program (AHTTP) was established to extend specialized hand care throughout Arkansas. The purpose of this study is to assess whether transfers are affected when consultation with a hand specialist is performed by phone compared with using a live audiovisual consultation. Methods We reviewed data from the first year of the AHTTP. Data collection included type of consultation (telephone only or live audiovisual), need for transfer, and type of transfer (general orthopedic or hand specialist). Results In 2014, the first year of AHTTP there were 331 hand injuries identified; of those, 298 used the AHTTP with 195 (65%) using telemedicine and 103 (35%) using phone consultation only. The use of video when compared with phone consultation did not significantly affect the decision to transfer ( P = .42) or alter the rate of transfer for general orthopedic or hand specialist care ( P = .25). Conclusions The assessment of both phone and telemedicine modalities showed that there was no significant difference in transfer rates for either consultation, highlighting that communication with a hand surgeon was the key to accurate assessment of the need for transfer.