Is Prehospital Emergency Telemedicine Implementation Feasible In Non‐Traditional EMS Settings: A Systematic Literature Review

Abstract

The rate of technology expansion is rapidly covering even the most remote parts of the globe and in the lowest resource settings. With globalization however, low and middle income areas are facing emerging health issues such as injuries and chronic medical conditions. With these illnesses, there are inevitable demands on emergency services. It has been thought that technology be utilized to augment emergency medical care in such settings where formal Emergency Medical Services. To aggregate and analyze the existing literature on the topic a systematic literature review was conducted. This study analyzed the existing literature on prehospital emergency care in settings in which no formal EMS services were utilized. Four databases were searched with inclusion and exclusion criteria, yielding 1782 results. The initial screening excluded all but 21 articles. Of the 21 articles in full review, 15 were included in the final review. Studies included in the final review were grouped into those reporting outcomes from five categories: Feasibility, Quality of Care, Response Time, Patient Outcomes, and Cost Effectiveness. Only one study was identified to be of high quality. There was a lack of studies with adequate statistical analysis to conduct statistical aggregation. Most studies however reported prehospital telemedicine in settings without EMS to be feasible, provide quality care, are be cost effective. However, the lack of statistical analysis makes it difficult to make conclusions. Also, several studies did show response time of a trained basic life support volunteer to be faster than EMS in many of the settings. But no positive health outcomes were observed in patients treated with projects utilizing technology in the prehospital setting. The prehospital emergency medicine setting is a young field of study that may have significant hurdles in application. The studies conducted have shown promise in the use of technology in prehospital settings without formal EMS services, but are not robust enough to make strong conclusions or recommendations that could be put into practice. Thus, more robust, statistically oriented research is imperative in the field so that we can fully explore the potential of technology in the prehospital setting, especially in low resource and rural settings without formal EMS services. With more robust studies, we can hope to integrate new technologies into practice and better serve the populations without adequate EMS coverage to provide more timely emergency care.