Acute Care Use and Mortality by Tele-Emergency Care Use, Modality, and Clinician Type

Is tele-emergency care associated with less subsequent care use and better outcomes compared with nurse triage alone?In this cohort study of 2 511 932 nurse advice line calls from 719 028 US veterans, tele-emergency care receipt was associated fewer emergency department (ED) visits within 7 days compared with propensity score–weighted encounters without tele-emergency care, with larger differences among higher-acuity calls. Facility-level implementation was associated with smaller and more heterogeneous changes in ED use; differences by modality and clinician type were modest.Results of this study suggest that tele-emergency care is associated with reduced ED use and may be a scalable flexible strategy to mitigate ED crowding.

Corresponding Author: Kathleen Yinran Li, MD, MS, Department of Emergency Medicine, University of Washington School of Medicine, 1705 NE Pacific St, Box 257235, Seattle, WA 98195 (kathyli@uw.edu).

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