Telehealth Reduces ED Errors

By Katie Wike, contributing writer

Rural emergency department doctors make fewer medication errors when they consult with other physicians via video conferencing

A study published in the journal Pediatrics found when emergency room doctors without access to specialists can consult with one through video conferencing, fewer medication errors are made. This is of particular importance in rural areas where there are fewer critical cases resulting in ED doctors not being as familiar with certain illnesses. Additionally, these rural facilities often don’t have specialists on staff.

For the study, researchers looked at 234 cases of children with serious illnesses in eight rural emergency departments in Northern California and found:

• physicians used telemedicine technology to consult with a pediatric critical care specialist in 73 cases
• physicians consulted with specialists over the phone in 85 cases
• physicians did not consult with a specialist at all in 76 cases
• Seventy-two percent of the children were given at least one medication

Reuters reports that with telemedicine consultations, 146 medications were administered and only 5 of those were either incorrect for the condition or administered incorrectly. In comparison, without consultations there were 16 errors for every 128 drugs administered, and when consultations were conducted over the phone there were 18 errors out of 167 drugs administered.

"We know that we make a difference by being able to see the patient," Dr. James Marcin said, the study's senior author and member of the telemedicine team at the University of California Davis Children's Hospital in Sacramento. Marcin went on to note the difference between phone and video consultations by saying, "The difference between the doctor coming in to do an office visit with you with his or her eyes closed, versus with his or her eyes open."

Video conferencing also gives specialists the opportunity to really get involved in a patient’s case and express their opinions on treatment according to Marcin.

"The amount of information that you can gather in a telemedicine consultation is typically much richer than what you can gather from a telephone conversation," said Dr. Alejandro J. Lopez-Magallon, who studies telemedicine at the Children's Hospital of Pittsburgh of UPMC. "Also, the level of interaction with the remote care team widens because you're not talking with a single person on the other side – you can interact with the remote physician or physicians and nursing staff, support staff and the patient and family themselves."

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