Report: Telemedicine May Reduce Errors by Rural Trauma Surgeons

As more and more hospitals and government agencies are turning to technology to serve the hardest-to-reach populations, a new report by the American College of Surgeons says telemedicine can prevent plenty of unnecessary suffering.
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As more and more hospitals and government agencies are turning to technology to serve the hardest-to-reach populations, a new report by the American College of Surgeons says telemedicine can prevent plenty of unnecessary suffering.

According to Rafael Grossmann, MD, FACS, lead study author and general surgeon at Eastern Maine Medical Center in Bangor, an analysis of 59 telemedicine consultations has shown fewer medical errors and a virtual elimination of unnecessary transport compared with telephone consultations. At Eastern Maine Medical Center (a Level II trauma center), surgeons provide consultation via telemedicine to 11 satellite centers, serving the needs of about 462,000 people in an area the size of Vermont, New Hampshire, and Massachusetts combined.

Telemedicine can help health care providers in rural areas stabilize and treat trauma victims when long distances or inclement weather prevents immediate transfer to an accredited trauma center, the study said.

The report was issued Oct. 13 at the 95th annual Clinical Congress of the American College of Surgeons.

The Eastern Maine system, known as TeleTrauma, uses high-resolution video with synchronized audio via an Internet connection. While telemedicine is not a new concept in medicine, the study by Dr. Grossmann and colleagues illustrates how surgeons are using this technology to expedite emergency care to underserved areas and how it can impact care.

In the study, the level of medical errors in the TeleTrauma group was about one-quarter of that in the telephone consultation group. Unnecessary transfers were seen only in the telephone consultation group.

“There is a shortage of surgeon coverage for rural areas in the United States, and this is an improved way of communicating with local providers and expanding the reach of trained trauma surgeons in Maine,” said Grossmann. “The study authors also found that telemedicine improved surgeon preparation when receiving cases, enhanced cooperation between providers on both ends of the connection, and increased satisfaction among patients and families in understanding treatment plans.”

TeleTrauma has also proved valuable in treating burn victims.

“It is very difficult to objectively quantify burns,” said Grossmann. “Having one of us look at the burn wounds over the high-resolution camera, we can say, ‘Yes, you can treat that locally with pain control,’ or ‘This is way over your and our heads. This patient will have to go to an ABA/ACS-certified burn center.’ The closest one is in Boston, and the helicopter can go directly from the local hospital to Boston.”

Barbara Sorondo, MD, MBA; Joanmarie Dietz Pellegrini, MD, FACS; David Jay Burke, MD, FACS; David Rydell, DO; Rony Ramia, MD; Amy Fenwick, MD; Pret Bjorn, RN; Robert E. Holmberg, MD, MPH, FACS; and Joseph Karem, MS, also participated in the telemedicine study.

More telemedicine coverage:
Project ECHO, an Innovative Telemedicine Program in New Mexico (with video)
Polycom Boosts Telemedicine Programs in Ontario (with video)

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