Three years of tele-emergency medicine with mobile on-site audio-video streaming in lower Saxony, Germany - descriptive results of a longitudinal secondary data analysis.

Background: Pre-hospital emergency medicine has been facing major challenges for several years due to increasing numbers of emergency calls, limited personnel resources and difficulties in staffing. A tele-emergency physician system provides immediate on-site emergency medical assistance and can support and guide emergency service personnel directly, thereby promoting the optimal use of available resources. Since January 2021, tele-emergency physicians have been deployed as part of a pilot project in the Goslar district in Lower Saxony, Germany. The aim of this study was to conduct a descriptive analysis of changes in on-site emergency physician missions and tele-emergency physician missions between 2021 and 2023.

Methods: To address this research question, a retrospective secondary data analysis of mission protocols was conducted. After data preparation, a descriptive data analysis was performed. Correlation analyses were conducted to compare on-site emergency physician missions and tele-emergency physician missions. Additionally, a technology questionnaire was completed by the tele-emergency physicians after every mission over a period of one and a half years and descriptively analysed to assess connection interruptions during tele-emergency physician missions.

Results: From 2021 to 2023, annual on-site emergency physician missions decreased from 5210 to 3623, and tele-emergency physician missions declined from 1632 to 1066. In terms of mission and treatment durations, there was a statistically significant difference between on-site emergency physician and tele-emergency physician missions across all three years. Between 1 May 2022 and 31 October 2023, 3.3% of tele-emergency physician missions were interrupted.

Conclusion: The findings from this pilot project confirm existing data from other studies and demonstrate that tele-emergency physician systems are an efficient resource in pre-hospital emergency medical services. They relieve emergency physicians in low-priority cases and, after an initial learning curve, from higher-priority cases as well. Furthermore, tele-emergency physicians can be deployed across all diagnostic categories.

Clinical trial number: Not applicable - secondary data analysis.