Abstract
The right person in the right place and at the right time is not always possible; telemedicine offers the potential to give audio and visual access to the appropriate clinician for patients. Advances in information and communication technology (ICT) in the area of video-to-video communication have led to growth in telemedicine applications in recent years. For these advances to be properly integrated into healthcare delivery, a regulatory framework, supported by definitive high-quality research, should be developed. Telemedicine is well suited to extending the reach of specialist services particularly in the pre-hospital care of acute emergencies where treatment delays may affect clinical outcome. The exponential growth in research and development in telemedicine has led to improvements in clinical outcomes in emergency medical care. This review is part of the LiveCity project to examine the history and existing applications of telemedicine in the pre-hospital environment. A search of electronic databases including Medline, Excerpta Medica Database (EMBASE), Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant papers was performed. All studies addressing the use of telemedicine in emergency medical or pre-hospital care setting were included. Out of a total of 1,279 articles reviewed, 39 met the inclusion criteria and were critically analysed. A majority of the studies were on stroke management. The studies suggested that overall, telemedicine had a positive impact on emergency medical care. It improved the pre-hospital diagnosis of stroke and myocardial infarction and enhanced the supervision of delivery of tissue thromboplasminogen activator in acute ischaemic stroke. Telemedicine presents an opportunity to enhance patient management. There are as yet few definitive studies that have demonstrated whether it had an effect on clinical outcome.
Highlights
There is a critical global shortage of healthcare professionals
The earliest implementation of modern telemedicine was by the National Aeronautics and Space Administration (NASA) in the 1960s when it was used for remote physiological monitoring of astronauts during manned space flights [4]
We found eight articles that were feasibility studies, while six articles explored the reliability of telemedicine
Summary
As a consequence, qualified professionals may not be physically present in under-resourced regions, and providing quality healthcare may be quite challenging. This challenge can be tackled by providing specialist medical services using information and communication technologies to remotely located healthcare workers and patients where telephone lines [2]. With the invention of the television in the 1950s, advances in closed-circuit television and video conferencing led to the adoption of telemedicine in patient monitoring and consultations [3]. NASA continued to play a pivotal role in the development of telemedicine with the development of the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) project on the Papago Indian Reservation in Arizona, USA, in 1972. These, in turn, have led to increased telemedicine use over the past 40 to 50 years with a subsequent increase in research since the 1990s
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