Low-Volume Emergency Departments are More Likely to Use Telehealth for Sepsis Care in a National Rural Telehealth Network

A Research & Policy Brief is available from the Rural Telehealth Research Center:

Sepsis is an expensive disease that is responsible for over 270,000 deaths in the U.S. annually. Early and aggressive treatment with antibiotics and hemodynamic resuscitation have been associated with improved outcomes, but many sepsis patients do not receive guideline-concordant care. Patients treated in low-volume emergency departments (EDs) have 38% higher mortality than those in high-volume EDs suggesting that volume is associated with elements of care that improve survival. Provider-to-provider ED-based telehealth (tele-ED) has been one strategy proposed to improve sepsis care in low-volume EDs. In tele-ED, local ED staff can request consultation with a remote physician and nurse who can connect using a 24-hour on-demand high-definition video connection allowing remote staff to see a patient, review records, provide advice, arrange for inter-hospital transfer, and provide clinical documentation. By connecting a clinician in a high-volume hospital with a care team in a low-volume hospital, rural sepsis patients and providers may benefit from high-volume experience and training even in a local rural facility.

The purpose of this study was to (1) report on the prevalence of tele-ED use for sepsis care across an established network, (2) quantify variation in use between hospitals, and (3) identify predictors of tele-ED consultation in tele-ED-capable hospitals.