Distance Emergency Care Using Nurse Practitioners
Background & Goal
Providing rural emergency medical care is often difficult because of limited resources and a scarcity of medical providers, including physicians trained in emergency medicine. Many rural emergency departments are challenged by a workforce shortage as well as financial constraints. Previous telemedicine models were not well designed to provide affordable care to unstable or potentially unstable patients.
The TelEmergency Program utilizes real time video streaming via T-1 lines and specially trained nurse practitioners in rural emergency rooms across the state in order to provide quality, affordable medical care to patients in rural emergency departments.
TelEmergency, unlike many other telemedicine systems, provides real time, unscheduled emergency care to communities that need it the most. This system is available 24 hours a day, seven days a week for any type of consultation necessary for emergency room patients. Advance practice nurses provide emergency care in an affordable manner because the cost of a nurse practitioner is substantially less than contracted physician coverage. This program leverages the strength of nurse practitioners and is built around a multidisciplinary team. The result is high quality health care in areas that need it the most.
Evidence of Success
- Comparison of these rural hospitals’ operational data before and after implementation of the TelEmergency program reveal:
- 25% reduction in staffing costs
- 20.1% increase in local admissions
- 10.9% increase in patient transfers to a hospital for a higher level of care
- Analysis of the program’s operation reveal:
- Nearly 50% of all patients are evaluated collaboratively by the nurse practitioner and collaborating physician, while the remaining % of all patients were treated independently by the nurse practitioner.
- 62% of patients are discharged from the ED at the rural site, while 18% are transferred to other hospitals for a higher level of care.
- A specially trained nurse practitioner and a board certified emergency physician are linked via the telemedicine system for approximately $53,000 per month for full time coverage is used in comparison to a physician, that is not specifically trained in emergency medicine, which would be approximately $72,000 per month for full time coverage. The only other additional cost incurred by the rural hospital is the T-1 line, which costs $527 per month. This is a savings of approximately $18,500 a month.
- Has trained more than 45 nurse practitioners, who have implemented the program in 15 hospitals and treated over 150,000 patients since its inception.