The role of telehealth in sepsis care in rural emergency departments: A qualitative study of emergency department sepsis telehealth user perspectives.

<h4>Purpose</h4>Sepsis is a leading cause of hospitalization and death in the United States, and rural patients are at particularly high risk. Telehealth has been proposed as one strategy to narrow rural-urban disparities. The objective of this study was to understand why rural emergency...

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Main Authors: Nicholas M Mohr, Kimberly A S Merchant, Brian M Fuller, Brett Faine, Luke Mack, Amanda Bell, Katie DeJong, Edith A Parker, Keith Mueller, Elizabeth Chrischilles, Christopher R Carpenter, Michael P Jones, Steven Q Simpson, Marcia M Ward
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0321299
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Summary:<h4>Purpose</h4>Sepsis is a leading cause of hospitalization and death in the United States, and rural patients are at particularly high risk. Telehealth has been proposed as one strategy to narrow rural-urban disparities. The objective of this study was to understand why rural emergency department (ED) staff use provider-to-provider telehealth (tele-ED) and how tele-ED care changes the care for rural patients with sepsis.<h4>Methods</h4>We conducted a qualitative interview study between February 15, 2022, and May 22, 2023, with participants from upper Midwest rural EDs and tele-ED hub physicians in a single tele-ED network that delivers provider-to-provider consultation for sepsis patients. One interviewer conducted individual telephone interviews, then we used standard qualitative methods based on modified grounded theory to identify themes and domains.<h4>Findings</h4>We interviewed 27 participants, and from the interviews we identified nine themes within three domains. Participants largely felt tele-ED for sepsis was valuable in their practice. We identified that telehealth was consulted to facilitate interhospital transfer, provide surge capacity for small teams, to adhere with provider scope-of-practice policies, for inexperienced providers, and for patients with increased severity of illness or complex comorbidities. Barriers to tele-ED use and impact included increased sepsis care standardization, provider reluctance, and sepsis diagnostic uncertainty. Additionally, we identified that real-time education and training were important secondary benefits identified from tele-ED use.<h4>Conclusions</h4>Tele-ED care was used by rural providers for sepsis treatment, but many barriers existed that may have limited potential benefits to its use.
ISSN:1932-6203