UNIVERSITY OF ARKANSAS SYSTEM
Rural areas are often medically underserved and represent about 20% of the U.S. population. Telemedicine holds considerable promise in alleviating many constraints imposed by time and distance on subspecialty health care encounters. As a consequence, services that only took place face-to-face in the past are moving out into the virtual world. Telemedicine can be used to provide subspecialty care for many health conditions in rural areas in a timely fashion; provide education for rural practitioners that may be many miles away from subspecialists; and it can be used to recruit patients and disseminate findings from translational research projects.
This supplement will expand our Community Based Research and Education Core Facility for community engagement through education and clinical care. This supplement will be used to purchase 6 telemedicine units to be placed in emergency departments (EDs) and pay for protected time to evaluate the effectiveness of this program in education and clinical care. An interactive monthly program for ED physicians and nurses, EDs PLACE (ED Physician Learning and Collaborative Education program), will be instituted and evaluated for effectiveness and relevance. This program will be compared to traditional face to face lectures. Trainees in ED medicine, internal medicine, family practice, and pediatrics will participate in the surveys to assess resident satisfaction and community ED physicians and nurses will also be surveyed. The effectiveness of consultations utilizing this medium will be assessed through surveys comparing telemedicine with telephone consultation alone. Community physicians will be asked to determine if consultation is needed with a subspecialist. If so, an initial telephone consultation will be followed by a telemedicine consultation with the academic center to determine disposition. The number of changes in treatment plans will be evaluated.
The problem is that while telemedicine indisputably has potential uses for education and clinical care, the potential is still unrecognized because of a lack of good clinical trials to document its effectiveness. This project will provide essential information for the design of optimal programs.