PROJECT SUMMARY/ABSTRACT
This proposal presents a research project focused on the study of a novel emergency telehealth strategy which
performs rapid screening, treatment, and discharge of patients presenting to the emergency department (ED)
with a low-acuity condition. This care delivery strategy facilitates timely discharges for eligible patients from an
ED triage room in a way that reserves ED capacity for patients with higher acuity or more complex
presentations that require an in-person evaluation. Clarifying guidance from the federal government pertaining
to the use of telehealth to conduct medical screening exams under the Emergency Medical Treatment and
Labor Act (EMTALA) made the implementation of the ETD workflow possible as of March 2020.
Given the novelty of this EMTALA exception, the use of telehealth to complete the assessment and discharge
of a patient from the ED without an in-person examination has not yet been evaluated. A better understanding
of the efficacy and safety of this care delivery strategy is needed to guide longer-term federal policies that
support Evaluate, Treat, Discharge (ETD) telehealth care for appropriate emergency department encounters.
The proposed project will assess the effects of this telehealth strategy on ED throughput, ED crowding, and
patient outcomes after discharge. This care delivery strategy not only has potential to improve emergency
preparedness, but also it can address long-standing pre-pandemic challenges with ED crowding. Additionally,
project findings will generate implications for ED operations and inform practice leaders on the efficacy and
safety of adopting this new approach to emergency telehealth.
The study addresses priorities highlighted in PA-18-794 by focusing on an innovative telehealth strategy that
harnesses technology with the goal of improving emergency care quality and patient outcomes. It also directly
addresses AHRQ priority populations, with a focused analysis of outcomes disparities among racial/ethnic
minorities and low-income individuals and the inclusion of sites located in inner city and rural settings. The
project will be executed by a multidisciplinary team with expertise in emergency health services research,
telehealth, and health econometric modeling. Since the data for this study is readily accessible to the study
team, with prior experience working with the data sources and performing the analytic procedures outlined in
the proposal, the team is well-positioned to execute the study with timely dissemination of project findings.
