Study suggests transfer of patients to EDs often unnecessary, raising opportunity for telemedicine

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Thirty-six percent of emergency department patients transferred to another facility for traumatic injury were later discharged without admission, observation or procedures, according to a study published in The American Journal of Emergency Medicine.

The researchers — led by Laura N. Medford-Davis, MD, an assistant professor of emergency medicine at Houston-based Baylor College of Medicine — used diagnostic codes to conduct a multistate analysis of 48,160 ED-to-ED injury transfers that took place in 2011.

Treatment at a receiving ED added $2,859 per discharged patient to the their total charge of care. Forty-nine percent of patients were transferred to non-trauma centers, 23 percent of whom had major trauma. The patients most likely to receive a discharge without procedure were those with soft tissue, head, facial or hand injuries.

The researchers suggested telemedicine consultations with sub-specialists may reduce the number of unnecessary transfers.

"Connecting patients and emergency physicians with sub-specialists virtually could reveal that no further care is needed before a costly transfer," Dr. Medford-Davis said. "We hope this research encourages change in how trauma patients with sub-specialty injuries are managed, and improves the communication between different hospital systems."

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