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BACKGROUND District General Hospital Emergency department referrals to a tertiary centre depend on information available from a ‘generalist’ clinician in discussion with a specialist team. If there is uncertainty, the lowest risk strategy is often to transfer the patient. Video consultation allowing the specialist team to see and talk to the patient and local clinician whilst still in the Emergency department could improve decision making about patient transfer. OBJECTIVE This study assessed the potential benefit of real time video consultation between remote specialist and Emergency department patient and clinician across all specialities. METHODS Detailed patient data was collected prospectively for 6 months (between 16th January and 15th July 2012) on all patients presenting to a District General Hospital Emergency department who required input from a specialist team in the nearest tertiary centre. These patients were discussed retrospectively with the specialist teams to determine whether video conferencing could have benefited the management of the patient. The logistics for use of videoconferencing were explored. RESULTS 18,799 patients were seen in the Emergency department during the study period. 413 referrals (2.2 %) were made to the tertiary centre specialist teams. Review of the patients transferred indicated 193 (46.7 % of transfer) might have benefited from video consultation (1.0 % of all patients). If the specialist team could be accessed via video conferencing only whilst a senior member was available in the hospital (08:00-22:00) then a maximum of only 5 patients per week across all specialities would use the equipment. If 24 hour specialist access was available this would increase to 7 patients per week. CONCLUSIONS In regions where there is direct transportation by ambulance of patients to specialist centres and there is regional Picture Archive and Communication System (PACS) then video consultation between emergency department patient and specialist has limited potential to improve patient management. CLINICALTRIAL
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Clarke et al. (2021) studied this question.