TY  - JOUR
AU  - Carolan, Kelsi
AU  - Grabowski, David C
AU  - Mehrotra, Ateev
AU  - Hatfield, Laura A
PY  - 2020
DA  - 2020/12/17
TI  - Use of Telemedicine for Emergency Triage in an Independent Senior Living Community: Mixed Methods Study
JO  - J Med Internet Res
SP  - e23014
VL  - 22
IS  - 12
KW  - telemedicine
KW  - telehealth
KW  - independent senior living communities
KW  - emergency care
KW  - first responders
AB  - Background: Older, chronically ill individuals in independent living communities are frequently transferred to the emergency department (ED) for acute issues that could be managed in lower-acuity settings. Triage via telemedicine could deter unnecessary ED transfers. Objective: We examined the effectiveness of a telemedicine intervention for emergency triage in an independent living community. Methods: In the intervention community, a 950-resident independent senior living community, when a resident called for help, emergency medical technician–trained staff could engage an emergency medicine physician via telemedicine to assist with management and triage. We compared trends in the proportion of calls resulting in transport to the ED (ie, primary outcome) in the intervention community to two control communities. Secondary outcomes were telemedicine use and posttransport disposition. Semistructured focus groups of residents and staff were conducted to examine attitudes toward the intervention. Qualitative data analysis used thematic analysis. Results: Although the service was offered at no cost to residents, use was low and we found no evidence of fewer ED transfers. The key barrier to program use was resistance from frontline staff members, who did not view telemedicine triage as a valuable tool for emergency response, instead perceiving it as time-consuming and as undermining their independent judgment. Conclusions: Engagement of, and acceptance by, frontline providers is a key consideration in using telemedicine triage to reduce unnecessary ED transfers. 
SN  - 1438-8871
UR  - http://www.jmir.org/2020/12/e23014/
UR  - https://doi.org/10.2196/23014
UR  - http://www.ncbi.nlm.nih.gov/pubmed/33331827
DO  - 10.2196/23014
ID  - info:doi/10.2196/23014
ER  -