Table 4.
Data extracted from articles
| Reference | Research questions | Number of included articles | Method | Application | Findings |
|---|---|---|---|---|---|
| Eder et al. (2018) |
1- Which telemedicine services in acute trauma care are implemented, and what was the nature of intervention? 2- What are the reported effects of telemedicine on acute trauma care by EMS? 3- Which methodologies were used to produce knowledge about telemedicine in included studies? |
15 | Tele-consultation | Providing services using tele-consultation which a paramedic would not normally be able to do |
1- Tele-consultation and pre-notification systems have the most utilization for acute trauma care 2- Its application improves patient’s condition |
| Telemedical pre-notification | Hospital care team awareness of patient’s condition while transferring the patient | ||||
| Winburn et al. (2018) | What is the level of adoption, the format of delivery, and the clinical focus for telehealth in pre-hospital emergency care? | 68 | Tele-consultation | Providing pre-hospital counseling for stroke, cardiovascular disease, and trauma |
1- It is best to utilize forward and store for cardiovascular diseases 2- Tele-consultation is commonly used for stroke patient care |
| du Toit et al. (2019) |
1- How has telehealth been used to manage noncritical emergency presentations? 2- What were the telehealth program outcomes? |
15 | Tele-consultation | Linking a small rural ED to a major ED center and receiving services and tele-consultation from specialists there |
1- Tele-consultation systems tend to be more accepted in places where nurses are the main provider 2- Its acceptance seems low in places where doctors are the main provider |
| Rogers et al. (2017) | How is telemedicine implemented and what are its benefits and effects? | 23 | Tele-consultation | Providing tele-consultation for on-site and ambulance paramedics by a specialist physician | System implementation outcomes have been positive and beneficial |
| Brainard et al. (2016) | Which health service interventions reduce the unplanned use of healthcare by rural populations? | 33 | Tele-consultation | Utilizing skills and equipment of major centers in cities by rural EDs | The use of these systems is especially cost-effective in rural areas |
| Salmoiraghi and Hussain (2015) | What are the effects and qualities of tele-psychiatry in emergency settings? | 23 | Tele-consultation | Providing psychological counseling and management services in the case of emergency |
1- Tele-consultation improves accessibility 2- Cost reduction |
| Ward et al. (2015) | What is the impact of hospital-based telemedicine systems in emergency care settings? | 38 | Tele-consultation | Decision support for diagnosis and treatment |
1- Most studies have had positive and beneficial outcomes 2- Research design and statistic assessment of studies was not robust enough |
| Telepresence | The remote physician has the role of on-site physician | ||||
| Kimmel et al. (2019) | Which alert systems improve outcomes and which types of alerts are effective? | 10 | Telemedical notification | Integrating care plans with the electronic health record (EHR) and sending reminder to provider at the desired time |
1- Telemedical notification reduces costs 2- It improves resource consumption 3- The usability of telemedicine systems requires further research |
| Kelton et al. (2018) | – | 11 | Tele-consultation | Using less expensive care providers, e.g., a nurse, alongside a remote physician |
1- The highest rate of implementation of these systems is in countries with diffuse populations 2- The success of these systems seems to lie not in the specialized services provided but in the ability to support patients in need of urgent care who may not receive the necessary quality care in other ways |
| Marsh-Feiley et al. (2018) | Is tele-sonography feasible, diagnostically accurate, and clinically useful in emergency settings? | 28 | Tele-sonography | A nonspecialist sonographer connecting a specialist through the system, and either the examination is done in real time, or the pictures are taken and then sent to the specialist |
1- Tele-sonography is applicable to a wide range of situations 2- Asynchronous communication was the most accessible among the available methods |
| Bashshur et al. (2016) | What does the current evidence say about the feasibility, acceptance, and effect of telemedicine in primary care? | 86 | Tele-consultation | Consultation of two specialists or providing tele-consultation for chronic patients instead of referrals to the ED |
1- Tele-consultation is effective in primary care 2- It is acceptable for both patient and provider 3- It improves the quality of service 4- It reduces costs |
| Gattu et al. (2016) | – | Not stated | Tele-consultation | Linking two centers and providing consultation |
1- They are usable and reliable 2- Further investigation is required in the case of pediatric emergency care |
| Tele-monitoring | Real-time remote monitoring of the patient’s physiological status, including vital signs | ||||
| Pak and Pak (2015) |
Does telemedicine offer clinical benefits? Does telemedicine offer the same outcomes with reduced costs? |
7 | Tele-consultation | Provider surveillance, X-ray interpretation, and EKG transmission prior to patient transfer to the center |
1- No clinical benefits were observed 2- It was safe and satisfactory |
| Guevorkian (2017) | What potential does telemedicine have in pre-hospital care? | 15 | Tele-consultation | Augmenting the efforts of non-professional health workers in low-resource settings | Studies have shown promising results, but more robust studies are needed to confirm the findings |
| Nadar et al. (2018) | What is the effect of telemedicine on clinical outcomes in pediatric acute care? | 24 | Tele-consultation |
Assessing the patient in real time, checking clinical data and medical files, observing medical images and monitoring equipment, and providing a beneficial and helpful remote consultation |
The use of telemedicine showed positive impacts, but more studies are needed |
| Lazarus et al. (2020) | Is tele-stroke usable for acute stroke management in rural settings? | 15 | Tele-consultation (tele-stroke) | Providing treatment remotely to stroke victims in rural communities | Telemedicine showed promising results, but further studies are needed to confirm these findings |
| Boggan et al. (2020) | Is remote triage feasible and beneficial for acute settings? | 8 | Tele-consultation (remote triage) | Triaging patients to the appropriate level of care through the use of technological systems that facilitate remote decision-making | There is limited evidence supporting the feasibility of remote triage in acute settings |
| Culmer et al. (2019) | Is ambulance-based telemedicine effective? What is its effect on quality, cost, and satisfaction? | 13 | Tele-consultation |
Transmission of patient data from an ambulance to a hospital’s ED or physician |
1- Telemedicine is effective in reducing costs 2- Quality of care is as good or even better when using telemedicine 3- Increased efficiency when using telemedicine due to reduced number and time of travel and also time of care |