Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T22:27:07.388Z Has data issue: false hasContentIssue false
  • English
  • Français

Using Telemedicine in Mass Casualty Disasters

Published online by Cambridge University Press:  05 February 2020

Megan E. Gregory ,
Shirley C. Sonesh ,
Ashley M. Hughes ,
Antonio Marttos ,
Carl I. Schulman  and
Eduardo Salas
Megan E. Gregory*
Affiliation:
Assistant Professor, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio Assistant Professor, Center for the Advancement of Team Science, Analytics and Systems Thinking in Health Services Research (CATALYST), The Ohio State University College of Medicine, Columbus, Ohio
Shirley C. Sonesh
Affiliation:
Founder, Sonnenschein Consulting, LLC. New Orleans, Louisiana
Ashley M. Hughes
Affiliation:
Assistant Professor, Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Illinois Research Health Scientist, Center of Innovations in Complex, Chronic Healthcare (CINCCH), Edward Hines JR VA Medical Center, Hines, Illinois
Antonio Marttos
Affiliation:
Associate Professor of Surgery, Dewitt Daughtry Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida Director of Global e-Health /Trauma Telemedicine, William Lehman Injury Research Center, Division of Trauma & Surgical Critical Care, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
Carl I. Schulman
Affiliation:
Professor of Surgery, Dewitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida Director of William Lehman Injury Research Center, Division of Trauma & Surgical Critical Care, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
Eduardo Salas
Affiliation:
Professor and Allyn R. & Gladys M. Cline Chair, Department of Psychological Sciences, Rice University, Houston, Texas
*
Correspondence and reprint requests to Megan E. Gregory, 460 Medical Center Dr., Suite 516, Columbus, OH43210; (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The goal of this study is to test an implementation and examine users’ perceptions about the usefulness of telemedicine in mass casualty and disaster settings and to provide recommendations for using telemedicine in these settings.

Methods:

Ninety-two US Army Forward Surgical Team (FST) members participated in a high-fidelity mass casualty simulation at the Army Trauma Training Center (ATTC). Telemedicine was implemented into this simulation.

Results:

Only 10.9% of participants chose to use telemedicine. The most common users were surgeons and nurses. Participants believed it somewhat improved patient care, attainment of expert resources, decision-making, and adaptation, but not the timeliness of patient care. Participants reported several barriers to using telemedicine in the mass casualty setting, including (1) confusion around team roles, (2) time constraints, and (3) difficultly using in the mass casualty setting (eg, due to noise and other conditions).

Conclusions:

There appear to be barriers to the use and usefulness of telemedicine in mass casualty and disaster contexts. Recommendations include designating a member to lead the use of telemedicine, providing telemedical resources whose benefits outweigh the perceived cost in lost time, and ensuring telemedicine systems are designed for the conditions inherent to mass casualty and disaster settings.

Keywords

biodefencebioterrorismdisaster planningdisastersorganizational decision-making
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 15 , Issue 2 , April 2021 , pp. 208 - 215
Copyright
Copyright © 2020 Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Killeen, JP, Chan, TC, Buono, C, et al. A wireless first responder handheld device for rapid triage, patient assessment and documentation during mass casualty incidents. AMIA Annu Symp Proc. 2006;2006:429-433.Google Scholar
Office for Victims of Crime. Mass casualty shootings. Office for Victims of Crime website. https://ovc.ncjrs.gov/ncvrw2018/info_flyers/fact_sheets/2018NCVRW_MassCasualty_508_QC.pdf. Published 2018. (Accessed March 10, 2019).Google Scholar
Kunkel, KE, Karl, TR, Brooks, H, et al. Monitoring and understanding trends in extreme storms: state of knowledge. Bull Am Meteorol Soc. 2013;94(4):499-514.CrossRefGoogle Scholar
Rolston, DM, Meltzer, JS. Telemedicine in the intensive care unit: its role in emergencies and disaster management. Crit Care Clin. 2015;31:239-255.CrossRefGoogle ScholarPubMed
Garshnek, V, Burkle, FMJ. Applications of telemedicine and telecommunications to disaster medicine: historical and future perspectives. J Am Med Inform Assoc. 1999;6:26-37.CrossRefGoogle ScholarPubMed
Ross, J, Stevenson, F, Lau, R, et al. Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implement Sci. 2016;11:146-158.CrossRefGoogle Scholar
Bulik, RJ. Human factors in primary care telemedicine encounters. J Telemed Telecare. 2008;14:169-172.CrossRefGoogle ScholarPubMed
Broens, THF, Huis in’t Veld, RM, Vollenbroek-Hutten, MM, et al. Determinants of successful telemedicine implementations: a literature study. J Telemed Telecare. 2007;13:303-309.CrossRefGoogle ScholarPubMed
Valdiri, LA, Andrews-Arce, VE, Seery, JM. Training forward surgical teams for deployment: the US Army Trauma Training Center. Crit Care Nurse. 2015;35:e11-e17.CrossRefGoogle ScholarPubMed
Department of the Army. Employment of Forward Surgical Teams: Tactics, Techniques, and Procedures (FM 4-02-25). Washington, DC: Department of the Army; 2003.Google Scholar
Lambrecht, CJ. Telemedicine in trauma care: description of 100 trauma teleconsults. Telemed J. 1997;3:265-268.CrossRefGoogle ScholarPubMed
Gagnon, MP, Duplantie, J, Fortin, JP, et al. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?. Implement Sci. 2006;1:18-26.CrossRefGoogle Scholar
Obstfelder, A, Engeseth, KH, Wynn, R. Characteristics of successfully implemented telemedical applications. Implement Sci. 2007;2(1):25-36.CrossRefGoogle ScholarPubMed
Oviatt, SL. Human-centered design meets cognitive load theory: designing interfaces that help people think. In: Proceedings of the 14th ACM International Conference on Multimedia, Santa Barbara, California, 2006:871-880.Google Scholar
Gao, T, Kim, MI, White, D, et al. Iterative user-centered design of a next generation patient monitoring system for emegrency medical response. AMIA Annu Symp Proc. 2006:284-288.Google ScholarPubMed
Stanescu, A, Boerlu, C, Copotoiu, S-M. Mass casualty incidents and disaster participation in real versus simluated events in Romania. Acta Med Marisiensis. 2016;62:15-20.CrossRefGoogle Scholar
Mentler, T, Herczeg, M, Jent, S, et al. Routine mobile applications for emergency medical services in mass casualty incidents. Biomed Tech. 2012;57:784-787.CrossRefGoogle ScholarPubMed
Latifi, R, Weinstein, RS, Porter, JM, et al. Telemedicine and telepresence for trauma and emergency care management. Scand J Surg. 2007;96:281-289.CrossRefGoogle ScholarPubMed
Rojas-Munoz, E, Cabrera, ME, Andersen, D, et al. Surgical telementoring without encumbrance: a comparative study of see-through augmented reality-based approaches. Ann Surg. 2019;270:384-389.CrossRefGoogle ScholarPubMed
Mathieu, JE, Heffner, TS, Goodwin, GF, et al. The influence of shared mental models on team process and performance. J App Psychol. 2000;85:273-283.CrossRefGoogle Scholar
Cannon-Bowers, JA, Salas, E, Converse, SA. Shared mental models in expert team decision making. In: Castellan, NJ, ed. Individual and Group Decision Making. Hillsdale, NJ: Lawrence Erlbaum Associates; 1993:221-246.Google Scholar
Hancock, PA, Szalma, JL. Operator stress and display design. Ergon Des. 2003;11:13–8.Google Scholar
Han, SH, Hwan Yun, M, Kim, K-J, et al. Evaluation of product usability: development and validation of usability dimensions and design elements based on empirical models. Int J Ind Ergon. 2000;26:477-488.CrossRefGoogle Scholar
Coursaris, C, Kim, D. A qualitative review of empirical mobile usability studies. In: Proceedings of the 12th Americas Conference on Information Systems, Acapulco, Mexico, 2006:2885-2897.Google Scholar
Supplementary material: File

Gregory et al. supplementary material

Gregory et al. supplementary material

Download Gregory et al. supplementary material(File)
File 15.3 KB