A pilot study on feasibility and hypothesis exploration: reducing on-scene length of stay of the emergency teams via ambulance dispatch teleconsultation for prehospital examination

28/Apr/2025
A pilot study on feasibility and hypothesis exploration: reducing on-scene length of stay of the emergency teams via ambulance dispatch teleconsultation for prehospital examination
einstein (São Paulo). 28/Apr/2025;23:eAO1469.
View Article28/Apr/2025
A pilot study on feasibility and hypothesis exploration: reducing on-scene length of stay of the emergency teams via ambulance dispatch teleconsultation for prehospital examination
DOI: 10.31744/einstein_journal/2025AO1469
Highlights ■ Teleconsultation reduced on-scene time from 36.8 to 20.6 min (p=0.019). ■ Video-based prearrival anamnesis improved team efficiency. ■ Interventions and clinical profiles were similar across the groups. ■ Study supports broader telemedicine adoption in emergency care. ABSTRACT Objective: Ambulance transport time is an important metric in prehospital care. Limited studies have explored strategies to decrease on-scene time. We examined the effect of collecting telemedicine-based medical data during ambulance dispatch on the on-scene evaluation time of the prehospital team. […]
Keywords: Ambulances; Communication; Length of stay; Patient care team; Prehospital care; Remote consultation; Telemedicine; Transportation of patients
24/Jun/2024
Multidrug stewardship and adherence to guidelines in >200,000 direct-to-consumer Telemedicine encounters
DOI: 10.31744/einstein_journal/2024AO0707
Highlights Up to 75% of COVID-19 telemedicine patients receive unnecessary drugs; this highlights the need for research. This study assessed the effect of guideline training and feedback on 200,000 telemedicine visits in Brazil. Under 2% of patients with COVID-19 received non-guideline recommended antimicrobials, reflecting high adherence rates. Targeted interventions significantly enhance guideline compliance for safer telemedicine prescriptions. ABSTRACT Objective: The quality of care and safety for Telemedicine-discharged patients with suspected respiratory infections are closely related to low rates of prescriptions […]
Keywords: Communicable diseases; Coronavirus infections; COVID-19; Drug prescriptions; Guideline adherence; Patient discharge; Prescriptions; Quality Indicators, Health Care; Referral and consultation; Respiratory tract infections; Telemedicine
09/May/2024
Retrospective analysis of 1,203 cases of referral to a quaternary vascular surgery outpatient clinic within the Unified Health System, São Paulo, Brazil
einstein (São Paulo). 09/May/2024;22:eAO0676.
View Article09/May/2024
Retrospective analysis of 1,203 cases of referral to a quaternary vascular surgery outpatient clinic within the Unified Health System, São Paulo, Brazil
DOI: 10.31744/einstein_journal/2024AO0676
Highlights Forty-three percent of referrals from basic healthcare units to a specialized vascular surgical service were regarded as inappropriate. The main reasons for inappropriate referrals included study participants without an indication for surgery and those referred to the wrong specialty. A high proportion of inappropriate referrals resulted in the subutilization of highly complex services. Use of telemedicine will assist in reducing the rate of inappropriate referrals. ABSTRACT Objective: Consequently, in this study, we aimed to evaluate 1,203 cases of referral […]
Keywords: Patient-referral systems; Public health; Telemedicine; Tertiary care centers; Vascular surgical procedures
26/Feb/2024
Is it possible to estimate the number of patients with COVID-19 admitted to intensive care units and general wards using clinical and telemedicine data?
einstein (São Paulo). 26/Feb/2024;22:eAO0328.
View Article26/Feb/2024
Is it possible to estimate the number of patients with COVID-19 admitted to intensive care units and general wards using clinical and telemedicine data?
DOI: 10.31744/einstein_journal/2024AO0328
Highlights Developed models to forecast bed occupancy for up to 14 days and monitored errors for 365 days. Telemedicine calls from COVID-19 patients correlated withthe number of patients hospitalized in the next 8 days. ABSTRACT Objective: To develop and validate predictive models to estimate the number of COVID-19 patients hospitalized in the intensive care units and general wards of a private not-for-profit hospital in São Paulo, Brazil. Methods: Two main models were developed. The first model calculated hospital occupation as […]
Keywords: Big data; Coronavirus infections; COVID-19; Decision support systems, clinical; Forecasting; Pandemics; Resource allocation; Telemedicine
22/Feb/2024
Telemedicine and patients with heart failure: evidence and unresolved issues
DOI: 10.31744/einstein_journal/2024RW0393
ABSTRACT Heart failure is the leading cause of cardiac-related hospitalizations. Limited access to reevaluations and outpatient appointments restricts the application of modern therapies. Telemedicine has become an essential resource in the healthcare system because of its countless benefits, such as higher and more frequent appointments and faster titration of medications. This narrative review aimed to demonstrate the evidence and unresolved issues related to the use of telemedicine in patients with heart failure. No studies have examined heart failure prevention; however, […]
Keywords: Heart failure; Morbidity; Mortality; Telecare; Telemedicine
30/Aug/2023
Brazilian Medical Survey on Telemedicine since the onset of COVID-19
DOI: 10.31744/einstein_journal/2023AE0428
Highlights Telemedicine played a major role in healthcare during the COVID-19 pandemic. A statistically significant number of physicians started using Telemedicine since the onset of COVID-19 pandemic. Most physicians approve its use and intend to continue using Telemedicine in their daily practice. Objective The primary aim of this study was to understand the difference in the use of Telemedicine by Brazilian physicians before and after the onset of COVID-19 pandemic and their intention to continue using it post the pandemic […]
Keywords: Health Behavior; Telemedicine; Telemonitoring
19/Dec/2022
Mobile application-based oximetry: a potential tool for appropriate referral of patients with respiratory symptoms examined via telemedicine
einstein (São Paulo). 19/Dec/2022;21:eAO0025.
View Article19/Dec/2022
Mobile application-based oximetry: a potential tool for appropriate referral of patients with respiratory symptoms examined via telemedicine
DOI: 10.31744/einstein_journal/2023AO0025
Highlights The evaluated method showed moderate reproducibility when compared to the gold standard practice. This new method had a high specificity and a low sensitivity. The observed high range of SpO2 levels between the methods could lead to a wrong patient referral. The use of telemedicine to assess oxygen saturation in patient with dyspnea is a viable resource, although requiring improvement. ABSTRACT Objective To calculate the positive likelihood ratio to determine whether telemedicine is able to optimize referral to […]
Keywords: Artificial intelligence; Dyspnea; Oximetry; Referral and consultation; Respiratory tract diseases; Signs and symptoms; Telemedicine
18/May/2022
Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial
einstein (São Paulo). 18/May/2022;20:eAO6800.
View Article18/May/2022
Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial
DOI: 10.31744/einstein_journal/2022AO6800
ABSTRACT Objective To analyze telemedicine diagnostic accuracy in patients with respiratory infections during COVID-19 pandemic compared to face-to-face evaluation in the emergency department. Methods Randomized, unicentric study between September 2020 and November 2020 in patients with any respiratory symptom (exclusion criteria: age >65 years, chronic heart or lung diseases, immunosuppressed). Patients were randomized 1:1 for brief telemedicine followed by face-to-face consultation or direct face-to-face evaluation. The primary endpoint was the International Classification of Diseases code. The secondary analysis comprised length […]
Keywords: Coronavirus infections; COVID-19; Emergency medical services; Referral and consultation; Respiratory tract infections; Telemedicine
26/Nov/2020
Assessment of patients with acute respiratory symptoms during the COVID-19 pandemic by Telemedicine: clinical features and impact on referral
einstein (São Paulo). 26/Nov/2020;18:eAO6106.
View Article26/Nov/2020
Assessment of patients with acute respiratory symptoms during the COVID-19 pandemic by Telemedicine: clinical features and impact on referral
DOI: 10.31744/einstein_journal/2020AO6106
ABSTRACT Objective: To characterize variables associated with referral to the emergency department following Telemedicine consultation during the COVID-19 pandemic. Methods: Cross-sectional retrospective study conducted between March and May 2020, with a sample of 500 adult patients. The inclusion criterion was the manifestation of respiratory symptoms, regardless of type. Results: The mean age of patients was 34.7±10.5 years, and 59% were women. Most patients (62.6%) perceived their own health status as malaise and some (41.4%) self-diagnosed COVID-19. Cough (74.4%), rhinorrhea (65.6%), […]
Keywords: Coronavirus infections; Pandemics; Referral and consultation; Respiratory tract infections; Telemedicine
12/Nov/2020
Application of blended care as a mechanism of action in the construction of digital therapeutics
einstein (São Paulo). 12/Nov/2020;18:eMD5640.
View Article12/Nov/2020
Application of blended care as a mechanism of action in the construction of digital therapeutics
DOI: 10.31744/einstein_journal/2020MD5640
ABSTRACT The article describes the use of blended care as a mechanism of action in the construction of a therapy that uses digital means to improve and support current clinical treatments. The so-called digital therapeutics provides evidence-based therapeutic interventions for patients, who are guided by software to prevent, manage, or treat a medical disorder or disease. They are used independently or together with drugs, devices, or other therapies to optimize patient care and health outcomes. They are similar to popular […]
Keywords: mHealth; Telemedicine; Therapeutics