Summary of "Teletrauma Use in US Emergency Departments"

This document provides an in-depth analysis of the usage of teletrauma in emergency departments (EDs) across the United States. Teletrauma involves using telehealth technologies to connect trauma specialists remotely to EDs, particularly in rural areas, where access to advanced trauma care is limited. The study examines data collected between 2016 and 2020 to assess the prevalence, trends, and barriers associated with teletrauma adoption.

Conclusion

The study reveals that teletrauma use in US EDs remains relatively low. In 2020, only 8.4% of emergency departments reported using teletrauma, in contrast to 60.4% that utilized other forms of telehealth services. Teletrauma was predominantly used in rural areas, with states like North Dakota (85.7%) and South Dakota (75.6%) reporting the highest adoption rates, while several states, including Alabama and Connecticut, did not report any teletrauma use. Key factors that contributed to the adoption of teletrauma included being a critical access hospital, which increased the likelihood of adoption (odds ratio 2.67), and having a basic stroke hospital designation (odds ratio 1.74). Despite its potential to improve trauma care in rural and underserved areas, teletrauma implementation still faces significant barriers, including a lack of comprehensive evidence supporting its effectiveness. Teletrauma adoption has not kept pace with other telehealth services, and further research is needed to explore the challenges and assess its impact on patient outcomes.

Key Points

Teletrauma adoption is relatively low, with only 8.4% of EDs reporting usage by 2020. In comparison, 60.4% of emergency departments had adopted other telehealth services. Teletrauma was most commonly used in rural areas, particularly in North Dakota and South Dakota, which had the highest rates of adoption. Factors contributing to teletrauma adoption include the critical access hospital designation and basic stroke hospital status. These factors significantly increased the likelihood of teletrauma implementation. Barriers to wider adoption include the lack of robust evidence for its effectiveness in improving trauma outcomes. Additionally, geographic disparities exist, with several states reporting no use of teletrauma services. The growth of teletrauma adoption between 2016 and 2020 was slow, with only a 2.4 percentage point increase over the five-year period, indicating that the service has not gained widespread traction. Teletrauma has the potential to reduce unnecessary patient transfers to advanced trauma centers, which could save costs and improve resource efficiency in trauma care. Despite its promise, teletrauma adoption significantly lags behind other telehealth services like telestroke, which have seen more successful integration into healthcare systems. The document highlights the need for more research to understand the barriers to teletrauma implementation and to assess its effectiveness in improving trauma care, especially in underserved and rural populations.

Summary

Teletrauma usage in emergency departments remains limited, with only a small percentage of facilities adopting the service. The study reveals that teletrauma adoption is mostly concentrated in rural areas, where access to trauma care is more difficult. Despite the broader adoption of telehealth services in general, teletrauma has not seen significant growth, and several states report no usage at all.

One of the main drivers of teletrauma adoption is the hospital's designation. Critical access hospitals and basic stroke hospitals are more likely to implement teletrauma. These hospitals, often located in rural areas, benefit from the service by gaining access to remote trauma expertise. This can reduce unnecessary transfers to advanced trauma centers, resulting in cost savings and more efficient use of healthcare resources.

However, teletrauma adoption faces several barriers. The lack of high-quality evidence supporting its effectiveness has slowed its growth. Additionally, there are significant geographic disparities in teletrauma usage, with some states lagging behind in implementation. Although teletrauma could significantly improve access to trauma care, especially in rural areas, the lack of a national strategy for its widespread adoption remains a challenge.

The study also compares teletrauma to other telehealth services, such as telestroke, which have been more successfully integrated into healthcare systems. While both stroke and trauma care are time-sensitive, telestroke has seen broader adoption due to a more established framework and evidence base. In contrast, teletrauma has yet to develop a similar foundation.

Further research is necessary to address these gaps and evaluate the effectiveness of teletrauma. This includes exploring the barriers to its implementation and understanding how it can better serve rural and underserved populations. The slow growth of teletrauma adoption indicates that more targeted efforts are needed to improve its integration into trauma care systems.

https://jamanetwork.com/journals/jamasurgery/fullarticle/2823887

Hashmi ZG, Rokayak O, Boggs KM, et al. Teletrauma Use in US Emergency Departments. JAMA Surg. Published online September 18, 2024. doi:10.1001/jamasurg.2024.3758