Implementing telemedicine in medical emergency response: concept of operation for a regional telemedicine hub

Abstract

A regional telemedicine hub, providing linkage of a telemedicine command center with an extended network of clinical experts in the setting of a natural or intentional disaster, may facilitate future disaster response and improve patient outcomes. However, the health benefits derived from the use of telemedicine in disaster response have not been quantitatively analyzed. In this paper, we present a general model of the application of telemedicine to disaster response and evaluate a concept of operations for a regional telemedicine hub, which would create distributed surge capacity using regional telemedicine networks connecting available healthcare and telemedicine infrastructures to external expertise. Specifically, we investigate (1) the scope of potential use of telemedicine in disaster response; (2) the operational characteristics of a regional telemedicine hub using a new discrete-event simulation model of an earthquake scenario; and (3) the benefit that the affected population may gain from a coordinated regional telemedicine network.

Fig. 1

Current hospital-based medical response process (Base Case)

Fig. 2

Telemedicine-enhanced hospital-based medical response

Fig. 3

Time-dependent mortality curves for critically injured

Fig. 4

Average arrivals by patient type for major through minor earthquake scenarios

Fig. 5

Average patient mortality outcomes for base and telemedicine scenarios, with major, medium, and minor-scale earthquakes

Fig. 6

Patient mortality: base case vs telemedicine vs shared telemedicine (Major Scale)