Real Time Tele-Monitoring and On-Line Medical Direction for Inter-Facility Transfer in The Critically Ill Patients

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Seathapong Thanoorat
Thanyaras Piyawatchwela

Abstract

Background and Objectives: The Tele-Monitoring system has been implemented in all public health hospitals in Khon Kaen Province since 2014. In 5 years later, On-line medical direction program has been initiated to provide real-time consultation for the healthcare personnel during transferring patients. The purposes of the system are to increase the confidence of providers and to enhance the safety management during inter-facility transfer. This study aimed to analyze the association between Tele-Monitoring system used and mortality in first 24 hours.    


Methods: It was a retrospective cohort study. The critically ill transferred patients from the rural hospitals to Khon Kaen hospital from October 2018 to September 2019 were enrolled. Descriptive Statistics were used for descriptive data. The association between Tele-Monitoring used and mortality within the first 24 hours was analyzed by Chi-square.  P-value <0.05 was set for statistical significance.


Results: There were 3,750 patients enrolled, 2,867 (75.5%) used the Tele-Monitoring system during inter-facility transfer. The mean age was 61.80±16.58 years, male sex was 63.7% and 11.1 % were trauma patients. The most common indication for the Tele-Monitoring used was ESI level 1. The mortality within first 24 hours was not different between Tele-Monitoring used and in non Tele-Monitoring used groups (p=0.978).


Conclusion: The Tele-Monitoring system is a high investment and maintenance of inter-facility. However, the Tele-Monitoring and On-line medical directions will help patients to receive treatment promptly along transferring with reducing death or disability.

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