Telegraphic Medicine Systems Improve Medical Diagnosis in Pre-Hospital Settings: A Pilot Study in a Tertiary Care Hospital
Soontorn Chinprasatsak MD*, Suparerk Satthapong MD*, Praew Kotruchin MD**, Kunakorn Maporn BS*
Affiliation : * Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand ** Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Non-physician responders mainly provide pre-hospital services or emergency medical service (EMS) in
Thailand due to shortage of emergency physicians. There is still high-risk for preventable death during pre-hospital care
and transfer. Telegraphic medicine is a promising strategy to solve this problem.
Objective : To determine the efficacy of telegraphic medicine systems in EMS during responses by advanced life support
teams.
Material and Method: This was a pilot study in a tertiary care setting. Telegraphic medicine systems were used in conjunction
with advanced life support teams. These systems included video and audio signals, electrocardiograms, and vital signs
transmitted from the pre-hospital scene and ambulance to a monitoring room in the hospital. We divided efficacy of telegraphic
medicine into four categories, primary diagnosis, proper airway management, proper circulatory management, and proper
neurological management. Experienced emergency physicians evaluated appropriateness of treatment in each category.
Results : There were 100 pre-hospital emergency patients enrolled in the present study. Twenty-seven patients were randomly
assigned to the telegraphic medicine group. Telegraphic medicine systems significantly increased the percentage of cases
with primary diagnosis. They also increased the percentages of patients receiving appropriate airway, circulatory, and
neurological management, but was not statistically significant.
Conclusion : Telegraphic medicine was shown to increase the percentage of patients who received a primary diagnosis, as
well as the percentages of those who received appropriate diagnoses, airway, circulatory, and neurological management.
Thus, it is a promising system for EMS in Thailand.
Keywords : Telemedicine, Tele-health, Pre-hospital, EMS
