Evidence map›Paper›PMID 35228006›Full record

ArticleInternational journal of medical informatics2022

Impact of telemedicine on clinical practice patterns for patients with chest pain in the emergency department.

Nicolai Ostberg, Wui Ip, Ian Brown, Ron Li

Abstract read
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Article in International journal of medical informatics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Nicolai OstbergDepartment of Biomedical Data Science Stanford University School of Medicine Stanford, CA, USA. Electronic address: nostberg@stanford.edu.
Wui IpDepartment of Pediatrics Stanford University School of Medicine Stanford, CA, USA.
Ian BrownDepartment of Emergency Medicine Stanford University School of Medicine Stanford, CA, USA.
Ron LiDepartment of Medicine Stanford University School of Medicine Stanford, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe outbreak of the COVID-19 pandemic has led to the rapid adoption of novel telemedicine programs within the emergency department (ED) to minimize provider exposure and conserve personal protective equipment (PPE). In this study, we sought to assess how the adoption of telemedicine in the ED impacted clinical order patterns for patients with chest pain. We hypothesize that clinicians would rely more on imaging and laboratory workup for patients receiving telemedicine due to limitation in physical exams.

methodsA single-center, retrospective, propensity score matched study was designed for patients presenting with chest pain at an ED. The study period was defined between April 1st, 2020 and September 30th, 2020. The frequency of the most frequent lab, imaging, and medication orders were compared. In addition, poisson regression analysis was performed to compare the overall number of orders between the two groups.

results455 patients with chest pain who received telemedicine were matched to 455 similar patients without telemedicine with standardized mean difference < 0.1 for all matched covariates. The proportion of frequent lab, imaging, and medication orders were similar between the two groups. However, telemedicine patients received more orders overall (RR, 1.19, 95% CI, 1.11, 1.28, p-value < 0.001) as well as more imaging, lab, and nursing orders. The number of medication orders between the two groups remained similar.

conclusionsFrequent labs, imaging, and medications were ordered in similar proportions between the two cohorts. However, telemedicine patients had more orders placed overall. This study is an important objective assessment of the impact that telemedicine has upon clinical practice patterns and can guide future telemedicine implementation after the COVID-19 pandemic.

Indexed as

COVID-19TelemedicineChest PainEmergency Service, HospitalHumansPandemicsPractice Patterns, Physicians'Retrospective StudiesCare deliveryChest painEmergency departmentTelemedicine

Identifiers

PMID35228006
PMCPMC8864961

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.