[The tele-emergency physician system as a tool in preclinical emergency care: A stocktaking report on the quality of care based on selected characteristics]

Abstract

Introduction: Due to the increasing proportion of older people in the German population, the age group-specific burden of disease is also rising, which consequently leads to an escalating need for emergency medical care in the preclinical sector. Within the German health care system, the growing shortage of physicians and the associated deficit of emergency physicians are further aggravating factors, which can lead to relevant gaps in care.

Methods: Through a systematic literature search for the period from January 1, 2000 to March 1, 2023 on prehospital telemedical emergency services (tele-EMS), selected quantitative and qualitative characteristics according to the PICOS scheme and the PRISMA statement were made available as examples; these were then used to critically categorize the quality of telemedically supported emergency care in Germany.

Results: The 23 selected publications comprised 17 clinical trials (including five quasi-experimental, ten observational, and two mixed-methods studies), four simulation studies, and two surveys. The incidence of technical problems ranged from 3% to 20% in the trials. Overall, the majority showed benefits in terms of faster availability of emergency medical expertise on scene together with a shortening of the treatment-free interval. The studies also indicated that patient registrations at the hospital providing further treatment took place at an earlier time. Furthermore, a reduction in the number and duration of emergency medical interventions was also evident.

Conclusion: Currently, there still is a considerable need for optimization both with regard to the nationwide establishment of the tele-EMS and its design in already existing digital support systems. To be able to guarantee a customized continuity of care, a goal-oriented application and expansion of a digital infrastructure in the field of emergency medicine offers an option for guaranteeing up-to-date and qualitatively acceptable preclinical emergency care.

Keywords: Characteristics; Country; Emergency medicine; Evaluation; Land; Merkmale; Notfallmedizin; Quality of care; Tele-emergency physician; Telenotarzt; Versorgungsqualität.