Telemedicine medical evaluation of low-risk patients with dengue during an outbreak may be an option in reducing the need for on-site physicians

International Journal of Infectious Diseases

Tarso A.D. Accorsi¹  Flavio Tocci Moreira²  Gustavo A. Cunha³  Eduardo Cordioli⁴  Karine De Amicis Lima⁵  Marcus V.B. Gaz⁵  Carlos H.S. Pedrotti⁵  Renata A. Morbeck⁵  Karen Francine Köhler⁵  Murilo Chiamolera⁵  Ary Serpa Neto⁵ 

[1] Corresponding Author: Carlos H.S. Pedrotti, MD, Av. Albert Einstein, 627. Bloco B, 2 andar, Secretaria da Unidade de Telemedicina. Sāo Paulo, SP. 05652-900, Brazil. Phone: [phone];Fax: [phone].;Emergency Department, Hospital Israelita Albert Einstein, Sāo Paulo, Brazil;Intensive Care Department, Hospital Israelita Albert Einstein, Sāo Paulo, Brazil;Telemedicine Department, Hospital Israelita Albert Einstein, Sāo Paulo, Brazil;

关键词: Telemedicine;    Dengue Fever;    Emergency Medical Services;    Outbreak;    Tropical Diseases;    Digital Health;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objective: To analyze the effectiveness of telemedicine consultations during an outbreak in reducing the need for face-to-face consultations at a field hospital for patients with dengue. Methods: We performed a retrospective unicentric study between April and May 2015 with 4626 patients (≥15 years old) who spontaneously sought care at an emergency field hospital (Sāo Paulo/Brazil). A nurse initially assessed all patients with dengue through rapid diagnostic testing, automated complete blood count, and risk stratification. During overcrowded situations, a video-based telemedicine consultation was provided as an option to all low-to-moderate risk patients who tested positive. The management was carried out according to current dengue guidelines. The primary end point was a referral to immediate face-to-face medical evaluation. Results: Of all patients suspected of dengue infection, 2003 presented positive testing, 1978 were classified as low-moderate risk, and 267 patients with dengue were evaluated by telemedicine. The mean age was 38.17 ± 13.7 years (54.6% female). Oral medications were recommended in 169 (63.3%), intravenous hydration or symptomatic drugs in 96 (36%), 252 (94.4%) were discharged after telemedicine assessment, and only 15 (5.6%) were referred to immediate face-to-face medical evaluation. No adverse events were recorded. Conclusion: Telemedicine medical assessment of low-to-moderate risk patients with dengue previously screened by nursing triage is effective in replacing the face-to-face evaluation in a field hospital. Telemedicine may be reinforced in epidemiological outbreak scenarios as a cost-effective strategy for the initial assessment of acute patients.

【 授权许可】

Unknown