Clinical trial NCT02228317: Emergency Medical Technician Treat-and-leave Patients Receiving Telemedicine Consultation With Emergency Medical Dispatch Physician - a Controlled Before and After Pilot-study
Official title: Emergency Medical Technician Treat-and-leave Patients Receiving Telemedicine Consultation With Emergency Medical Dispatch Physician - a Controlled Before and After Pilot-study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Acutely Ill
Acutely Injured
Keywords: Emergency Medical Dispatch
Telemedicine
Emergency Medical Services
Pre-hospital
Lead sponsor: University of Aarhus
Sponsor class: OTHER
Collaborators: name: Central Denmark Region
name: Aarhus University Hospital
First posted: 2014-08-29
Enrollment: 774
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: A large part of acutely ill patient's access to the health care system starts by calling the emergency number 1-1-2 and thereby getting in touch with the emergency medical dispatch center (EMDC). In most cases an ambulance is dispatched and the patient is brought to the hospital. These patients are not referred by a physician (eg. a GP) and represent an unselected subpopulation of the acutely ill patients. At present, all non-critically ill patients not evaluated by a pre-hospital physician are normally be transported to hospital as category 2 (without activated emergency lightning and sirens).A part of this patient population, however, is not critically ill and a proportion of these may not need hospital admittance . Emergency medical technicians (EM) are not allowed to treat - and- leave patients without a physician's involvement. If the EMT had 24/7 online access to medical control i.e. in form of a physician present in the EMDC , the number of patients transported to hospital for assessment may be reduced as well as response times for patients actually needing ambulance transportation. This could potentially reduce the workload on the whole healthcare system involved in the management of these patients - thereby potentially reducing costs.

The objective of this study is to evaluate if a systematic telemedical assessment by an EMDC-physician of all patients who receive an ambulance but are not critically ill and would have a category 2 transport to hospital can reduce the number of the patients that are transported to hospital and save costs and time.


Eligibility criteria: Inclusion Criteria:

* Patients receiving an emergency ambulance after calling the EMDC Patients who are going to be admitted to a Hospital in the Central Denmark Region.
* Patients who are going to be transported as category 2 patients (non-critical illness, not requiring transport with activated lightning and sirens.

Exclusion Criteria:

* Critically ill patients (Patients who are going to be transported as category 1 patients (critical-illness, requiring immediate transport with activated sirens and warning lights )
* Patients who are not supposed to be admitted to a hospital in the Central Denmark Region

Primary outcomes:
measure: Expenses related to EMDC physician vs. savings obtained by avoided admissions
timeFrame: Will be assessed at the time of consultation, expected to be presented within 36 months after assessment
Secondary outcomes:
measure: Percentage of avoided hospital admissions
timeFrame: Treated-and-left or not will be assessed at the time of consultation, expected to be presented within 36 months of assessment
measure: Response time for ambulances
timeFrame: Is assessed at the time the EMT registers arrival on site, expected to be presented within 36 months of assessment
measure: Hospital admission within 3 days
timeFrame: Will be assessed at the 72 hours after consultation, expected to be presented within 36 months of assessment
measure: Time consumption by EMDC physician
timeFrame: Will be assessed within 1 minute after end of consultation, expected to be presented within 36 months after assessment
measure: Cause of death
timeFrame: Will be assessed as soon as possible after the occurence of death, normally within 24 hours, expected to be presented within 36 months of assessment
measure: Patient's evaluation
timeFrame: Will be assessed within 72 hours after end of consultation, expected to be presented within 36 months after assessment
Other outcomes:
Locations:
city: Aarhus N
country: Denmark
facility: Prehospital Emergency Medical Services, Aarhus
Study officials:
References: