Effects of Telehealth Use for Rapid Screening, Treatment, and Discharge of Patients with Low-Acuity Conditions in the Emergency Department

远程医疗对急诊科低危患者快速筛查、治疗和出院的影响

• 批准号: 10527906
• 负责人: Jessica E Galarraga
• 金额: $ 10万
• 依托单位: MEDSTAR HEALTH RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10527906
• 关键词: Effects; Telehealth; Use; Rapid; Screening

PROJECT SUMMARY/ABSTRACT This proposal presents a research project focused on the study of a novel emergency telehealth strategy which performs rapid screening, treatment, and discharge of patients presenting to the emergency department (ED) with a low-acuity condition. This care delivery strategy facilitates timely discharges for eligible patients from an ED triage room in a way that reserves ED capacity for patients with higher acuity or more complex presentations that require an in-person evaluation. Clarifying guidance from the federal government pertaining to the use of telehealth to conduct medical screening exams under the Emergency Medical Treatment and Labor Act (EMTALA) made the implementation of the ETD workflow possible as of March 2020. Given the novelty of this EMTALA exception, the use of telehealth to complete the assessment and discharge of a patient from the ED without an in-person examination has not yet been evaluated. A better understanding of the efficacy and safety of this care delivery strategy is needed to guide longer-term federal policies that support Evaluate, Treat, Discharge (ETD) telehealth care for appropriate emergency department encounters. The proposed project will assess the effects of this telehealth strategy on ED throughput, ED crowding, and patient outcomes after discharge. This care delivery strategy not only has potential to improve emergency preparedness, but also it can address long-standing pre-pandemic challenges with ED crowding. Additionally, project findings will generate implications for ED operations and inform practice leaders on the efficacy and safety of adopting this new approach to emergency telehealth. The study addresses priorities highlighted in PA-18-794 by focusing on an innovative telehealth strategy that harnesses technology with the goal of improving emergency care quality and patient outcomes. It also directly addresses AHRQ priority populations, with a focused analysis of outcomes disparities among racial/ethnic minorities and low-income individuals and the inclusion of sites located in inner city and rural settings. The project will be executed by a multidisciplinary team with expertise in emergency health services research, telehealth, and health econometric modeling. Since the data for this study is readily accessible to the study team, with prior experience working with the data sources and performing the analytic procedures outlined in the proposal, the team is well-positioned to execute the study with timely dissemination of project findings.

项目总结/摘要 该提案提出了一个研究项目，重点是研究一种新的紧急远程医疗战略， 对急诊科（艾德）的患者进行快速筛查、治疗和出院 患有低敏度疾病这种护理提供策略有助于符合条件的患者及时出院， 艾德分诊室，保留艾德容量用于更高紧急度或更复杂的患者 需要亲自评估的演示文稿。澄清联邦政府有关 利用远程保健进行紧急医疗下的医疗筛查检查， 劳动法（EMTALA）使ETD工作流程的实施成为可能，截至2020年3月。 鉴于EMTALA例外的新奇，使用远程医疗来完成评估和出院 尚未对来自艾德的患者在未进行亲自检查的情况下的死亡率进行评价。更好地理解 这种护理提供战略的有效性和安全性需要指导长期的联邦政策， 支持评估，治疗，出院（ETD）远程医疗保健，以获得适当的急诊室服务。 拟议的项目将评估这种远程医疗策略对艾德吞吐量、艾德拥挤程度和 患者出院后的结局。这种护理提供战略不仅有可能改善紧急情况， 它不仅可以帮助人们做好准备，而且还可以解决艾德拥挤的长期流行前挑战。此外，本发明还 项目结果将对艾德运营产生影响，并向实践领导者通报有效性， 采用这种新的紧急远程保健方法的安全性。 该研究通过重点关注创新的远程保健战略来解决PA-18-794中强调的优先事项， 利用技术，以提高急诊护理质量和患者治疗效果为目标。也直接 解决AHRQ优先人群，重点分析种族/族裔之间的结果差异 少数民族和低收入个人的保护，以及将位于内城和农村地区的遗址包括在内。的 该项目将由一个具有紧急卫生服务研究专门知识的多学科小组执行， 远程保健和健康计量经济学建模。由于本研究的数据易于获得， 团队，具有使用数据源和执行 根据该建议，该小组完全有能力执行研究，并及时传播项目结果。