What Role Can Telehealth Play in Emergency Medicine?

In his latest book, COVID-19: The Great Reset, the Founder and Executive Chairman of the World Economic Forum, Professor Klaus Schwab, declared that the uptake in use of telemedicine throughout the pandemic showed that “a dramatic acceleration forced by necessity is possible”, adding that pre-pandemic, telemedicine was a technology “on the distant horizon in terms of adoption”.

It is undoubtable that the role of telehealth technology has soared throughout the pandemic, achieving levels of adoption that were previously thought unattainable. A recent study conducted by Becker’s Hospital Review found that before the pandemic, roughly 43% of Americans believed that they could receive the same level of care through telehealth platforms as opposed to in person consultations, whereas now, that figure has reached nearly 80%. Appetites are changing drastically, the question is now; what role can telehealth play in emergency medicine?

Telehealth platforms can prevent overcrowding in accident and emergency rooms, but theyalso allow physicians and medical practitioners to ensure their own safety and wellbeing while facilitating the provision of accessible medical care for their patients. In addition to this, telehealth services allow those that may be unable to access a medical practitioner, such as those living in rural areas, those without means of transport or even those with underlying health conditions during the pandemic that may be wary of journeying into a crowded emergency department.

While there is certainly a learning curve experienced by physicians in getting used to examining a patient online, at their core, telemedicine platforms allow medical practitioners to discern if a patient is experiencing a medical emergency, without having to be in the same room. This not only frees up space in emergency departments, but also allows hospital administrators to plan in advance for the rooms that they may require or even the equipment they may need at any given time.

In a practical sense, it may seem impossible for a medical practitioner to be able to evaluate a patient that would be arriving into an emergency room over a video call. However, the range of possibilities that this technology offers is far greater than one might expect. Long before the pandemic, a 2019 Johns Hopkins School of Medicine study found that “telescreening achieved the same level of efficiency as in-person screening” in the sample emergency department. This study also found that utilising telescreening during 1-3 am on weekdays “dramatically decreased the number of patients who left without being seen”, concluding that “[t]elescreening was an effective and safe way for this ED to expand the hours in which patients were screened by a healthcare provider”.

With the knowledge that a highly contagious and deadly virus like COVID-19 could potentially be carried from patient to patient by a doctor doing the rounds in an ED, the utilisation of telemedicine in emergency medicine should become a priority in all medical departments.

There is a lot that any medical practitioner can learn from a virtual visit to a patient’s home that might not be possible to learn from a brief check up in an emergency department. There is a lot that you can tell from a patient’s environment; is their home environment safe? Are there family members that can look after this person or drive them to a pharmacy if they are incapacitated? Utilising telemedicine is crucial in determining whether or not something needs to be evaluated acutely in person, and the benefits they provide should certainly be considere as we move forward beyond this pandemic.

The Spanish Flu pandemic in 1917 caused a paradigm shift in the administration of healthcare, which eventually resulted in the formation of many of the public health institutions we know and depend upon today, while also spurring multiple countries to create or revamp their own health services. It also caused the rise of the systematization of epidemiology, as well as the formation of what became the World Health Organization.

The COVID-19 pandemic has caused a paradigm shift in how we see telemedicine, which will undoubtedly resonate long after this pandemic is gone. Institutions and medical professionals made strides in public health and epidemiology in the wake of the Spanish Flu pandemic, which have greatly aided our efforts in combating the pandemic we face today. The 1917 pandemic spurred the medical field into identifying the problems it faced and proactively solving for the problems to come. We should do the same now, and use this pandemic as an opportunity to recognise the technology that will help the medical profession embark into the future.

Telemedicine is already a reality that can greatly assist our profession, but it is up to us to ensure it reaches its full potential. Patient-driven initiatives are likely to be significantly more powerful in determining the future of how healthcare is provided, but the medical profession must ensure that patients are aware of the benefits of technology such as telehealth. One thing is for certain; the events that unfolded over the last year proved to the world that when the bright minds of the medical world work together, we can overcome seemingly insurmountable feats.

Dr. Alyson J. McGregor, MD, MA, FACEP, Associate Professor of Emergency Medicine at The Warren Alpert Medical School of Brown University and the Co-Founder and Director for the Division of Sex and Gender in Emergency Medicine (SGEM) at Brown University’s Department of Emergency Medicine, author of ‘Sex Matters: How Male-Centric Medicine Endangers Women’s Health—and What We Can Do About It’, and registered physician on the Global Telehealth Exchange by Solve.Care.