Ms. Emily Mahony1, Ms. Nicole Magnuson1, Ms. Amanda Thornton1, Ms. Emily Nehme1, Dr. Susanne Scott1, Mr. David Shearer1, Dr. Jason Talevski2, Dr. Loren Sher2, Dr. Ziad Nehme1
1Ambulance Victoria, Blackburn North, Australia, 2Northern Health, Epping, Australia
Biography:
Biography to come.
Abstract:
Introduction: The establishment of an emergency medical services (EMS) pathway into the Victorian Virtual Emergency Department (VVED) service in October 2021, introduced a video-enabled telehealth consultation service with an emergency physician for EMS patients who may not need to attend the emergency department (ED). This study examined the utilisation of VVED within EMS and its subsequent impact on ambulance performance, service efficiency and patient care.
Methods: Presentations to emergency ambulance, between October 2021 to May 2023 were included if patients were referred to VVED by Ambulance Victoria (AV) paramedics and data were linked to VVED records. An equivalent control group was established utilising VVED inclusion/exclusion criteria.
Results: A total of 33,821 referrals to VVED were recorded during the study period, 24,350 (72%) non-COVID-19 presentations and 9,471 (28%) COVID-19-related presentations. Adult patients accounted for 90% of the study population, median (IQR) age 65 (40,82) years (38% male). Most patients were of mild clinical presentations; 7% with shortness of breath (respiratory rate [RR] ≥25), 15% with borderline hypoxia (oxygen saturation [SpO2] 92-94%) and 14% with chest pain. Compared to the control group, the median total case-time was shorter by 21 minutes. Of those referred to VVED, 75% were discharged at scene and not transported to hospital. By the completion of the study period, VVED was associated with a 9.4% improvement in Code 1 response performance.
Conclusion: VVED contributed to significant improvements in response performance, service efficiency and patient care, and has set a precedent for telehealth models of care within EMS.