Telemedicine Consultation and Referral System for Primary Care Patients Part 1: Three-year Experience in Coordinating Primary Care Network to the Emergency Department at Mae Sot Hospital, Tak
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Abstract
ABSTRACT
Background: Prehospital care is crucial in providing timely assistance to individuals during emergencies. Integrating telemedicine into emergency care systems has shown promising results in improving patient outcomes. Primary Care Units (PCUs) are important entry points for patients seeking medical assistance, particularly in remote areas. In the Mae Sot District, Tak Province, telemedicine consultation groups, which include Family Medicine and Emergency physicians, facilitate remote consultations and referrals, potentially improving patient care processes and outcomes. This study aimed to evaluate the clinical utilization of a telemedicine consultation group, known as the “FCT” (Family Care Team) LINE group, in streamlining consultations and referrals for primary care patients accessing the Emergency Department (ED) at Mae Sot Hospital in Tak Province, Thailand.
Methods: A retrospective observational study was conducted at Mae Sot Hospital, a general hospital near the Thailand-Myanmar border. Data were collected from patients who received consultations through the FCT LINE group and were referred to the ED from April 2021 to December 2023. Patient demographic information, consultation details, and outcomes were analyzed.
Results: One thousand two hundred sixty-five patients received consultations via the FCT LINE group during the study period. Among them, 18.2% were referred to the ED, while others were directed to primary care clusters, outpatient departments, or discharged. Most patients referred to the ED received appropriate initial management, with suitable referral methods. PCUs in remote areas had the highest number of cases referred. The average consultation waiting time was 9.5 minutes. Among ED referrals, the majority comprised adults and Thai nationals, with non-trauma cases being predominant. The median ED stay was 103 minutes, with 58% admitted, exhibiting a high discharge rate of 93.3% and a mortality rate of 5.2%.
Conclusions: The findings highlight the significant advantages of integrating telemedicine consultation groups into healthcare systems, particularly in enhancing patient care processes and resource utilization. Despite certain limitations, such as data collection scope and privacy concerns, the study emphasizes the importance of continuous quality improvement initiatives and further research to optimize the integration of telemedicine into emergency care systems
Keywords: primary care, telemedicine, emergency, referral system, prehospital care, healthcare delivery
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