Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trial
IntroductionThe emergency medical services (EMS) in Germany are facing several challenges in the near future. Due to the increasing number of emergency missions, the availability of EMS physicians is becoming more limited, resulting in longer response times. To maintain the high quality of EMS, tele...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Digital Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fdgth.2025.1519619/full |
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| author | Patrick P. Hess Patrick P. Hess Michael Czaplik Michael Czaplik Johanna Hess Hanna Schröder Hanna Schröder Stefan K. Beckers Stefan K. Beckers Andreas Follmann Mark Pitsch Mark Pitsch Marc Felzen Marc Felzen |
| author_facet | Patrick P. Hess Patrick P. Hess Michael Czaplik Michael Czaplik Johanna Hess Hanna Schröder Hanna Schröder Stefan K. Beckers Stefan K. Beckers Andreas Follmann Mark Pitsch Mark Pitsch Marc Felzen Marc Felzen |
| author_sort | Patrick P. Hess |
| collection | DOAJ |
| description | IntroductionThe emergency medical services (EMS) in Germany are facing several challenges in the near future. Due to the increasing number of emergency missions, the availability of EMS physicians is becoming more limited, resulting in longer response times. To maintain the high quality of EMS, telemedical support systems have shown potential as a valuable complement to the existing system for specific diagnoses. Since 2014, a tele-EMS system has been implemented in Aachen as an integrated telemedical solution alongside standard EMS. Accurate prehospital diagnosis plays a crucial role in ensuring appropriate hospital admission and reducing the time to clinical treatment for time-sensitive conditions. The main TEMS study demonstrated the overall non-inferiority of tele-EMS physicians compared to on-site EMS physicians. This sub-analysis focuses on comparing the diagnostic accuracy between these two groups.MethodsUp to four prehospital diagnoses were selected, coded according to the ICD-10 system, and compared with all admission and discharge diagnoses.ResultsThe comparison between diagnoses made by tele-EMS physicians and on-site EMS physicians with admission diagnoses showed no significant difference (p = 0.877). Additionally, no significant differences were found for the diagnoses of stroke (p = 0.385) and epileptic seizure (p = 0.738). However, patients from missions where paramedics decided to consult a tele-EMS physician had significantly longer hospital stays compared to those from missions where an on-site EMS physician was initially dispatched (p < 0.001).DiscussionThis randomized controlled analysis demonstrated that there is no difference in diagnostic accuracy between on-site EMS physicians and remote tele-EMS physicians. The significantly longer hospital stays for patients treated by tele-EMS physicians suggest that EMS physicians may be called too frequently for non-severe cases.
Clinical Trial Registrationclinicaltrials.gov, identifier (NCT02617875). |
| format | Article |
| id | doaj-art-848f8a79802d4dbc981714b4ae3c7f28 |
| institution | OA Journals |
| issn | 2673-253X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Digital Health |
| spelling | doaj-art-848f8a79802d4dbc981714b4ae3c7f282025-08-20T02:28:46ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2025-04-01710.3389/fdgth.2025.15196191519619Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trialPatrick P. Hess0Patrick P. Hess1Michael Czaplik2Michael Czaplik3Johanna Hess4Hanna Schröder5Hanna Schröder6Stefan K. Beckers7Stefan K. Beckers8Andreas Follmann9Mark Pitsch10Mark Pitsch11Marc Felzen12Marc Felzen13Department of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, GermanyDepartment of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyDocs in Clouds TeleCare GmbH, Aachen, GermanyDepartment of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyAachen Institute for Rescue Management & Public Safety, City of Aachen and University Hospital RWTH Aachen, Aachen, GermanyDepartment of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyAachen Institute for Rescue Management & Public Safety, City of Aachen and University Hospital RWTH Aachen, Aachen, GermanyDepartment of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyAachen Institute for Rescue Management & Public Safety, City of Aachen and University Hospital RWTH Aachen, Aachen, GermanyDepartment of Anesthesiology, Medical Faculty, RWTH Aachen University, University Hospital RWTH Aachen, Aachen, GermanyAachen Institute for Rescue Management & Public Safety, City of Aachen and University Hospital RWTH Aachen, Aachen, GermanyIntroductionThe emergency medical services (EMS) in Germany are facing several challenges in the near future. Due to the increasing number of emergency missions, the availability of EMS physicians is becoming more limited, resulting in longer response times. To maintain the high quality of EMS, telemedical support systems have shown potential as a valuable complement to the existing system for specific diagnoses. Since 2014, a tele-EMS system has been implemented in Aachen as an integrated telemedical solution alongside standard EMS. Accurate prehospital diagnosis plays a crucial role in ensuring appropriate hospital admission and reducing the time to clinical treatment for time-sensitive conditions. The main TEMS study demonstrated the overall non-inferiority of tele-EMS physicians compared to on-site EMS physicians. This sub-analysis focuses on comparing the diagnostic accuracy between these two groups.MethodsUp to four prehospital diagnoses were selected, coded according to the ICD-10 system, and compared with all admission and discharge diagnoses.ResultsThe comparison between diagnoses made by tele-EMS physicians and on-site EMS physicians with admission diagnoses showed no significant difference (p = 0.877). Additionally, no significant differences were found for the diagnoses of stroke (p = 0.385) and epileptic seizure (p = 0.738). However, patients from missions where paramedics decided to consult a tele-EMS physician had significantly longer hospital stays compared to those from missions where an on-site EMS physician was initially dispatched (p < 0.001).DiscussionThis randomized controlled analysis demonstrated that there is no difference in diagnostic accuracy between on-site EMS physicians and remote tele-EMS physicians. The significantly longer hospital stays for patients treated by tele-EMS physicians suggest that EMS physicians may be called too frequently for non-severe cases. Clinical Trial Registrationclinicaltrials.gov, identifier (NCT02617875).https://www.frontiersin.org/articles/10.3389/fdgth.2025.1519619/fulltelemedicineEMS-physicianparamedicsdiagnostic concordanceTEMS-study |
| spellingShingle | Patrick P. Hess Patrick P. Hess Michael Czaplik Michael Czaplik Johanna Hess Hanna Schröder Hanna Schröder Stefan K. Beckers Stefan K. Beckers Andreas Follmann Mark Pitsch Mark Pitsch Marc Felzen Marc Felzen Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trial Frontiers in Digital Health telemedicine EMS-physician paramedics diagnostic concordance TEMS-study |
| title | Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trial |
| title_full | Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trial |
| title_fullStr | Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trial |
| title_full_unstemmed | Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trial |
| title_short | Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service—a subanalysis of the TEMS-trial |
| title_sort | comparison of the diagnostic concordance of tele ems and ems physicians in the emergency medical service a subanalysis of the tems trial |
| topic | telemedicine EMS-physician paramedics diagnostic concordance TEMS-study |
| url | https://www.frontiersin.org/articles/10.3389/fdgth.2025.1519619/full |
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