Abstract
Overcrowding in emergency departments (EDs) is a global challenge, leading to prolonged waiting times and adverse patient outcomes. Telemedicine has emerged as a promising solution, enabling remote consultation, triage, and real-time specialist input. Despite its growing application, limited systematic research exists on its specific role in ED triage and care. This systematic review evaluated the effectiveness of telemedicine interventions in ED settings, focusing on diagnostic accuracy, patient satisfaction, throughput times, and re-admission rates. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted up to November 10, 2024. Eligible studies were randomized controlled trials (RCTs) in English that assessed telemedicine in ED settings. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the modified Downs and Black scale. Six RCTs met the inclusion criteria. Results showed that telemedicine improved diagnostic accuracy, reduced re-consultation rates, and enhanced treatment adherence. High diagnostic concordance with in-person assessments was observed, particularly in non-critical cases. Several studies reported shorter throughput times and higher patient satisfaction with telemedicine compared to traditional care. However, telemedicine's impact on high-acuity cases, such as emergency airway management, was less pronounced. Limitations included small sample sizes and the inability to blind participants, which may have influenced outcomes. Telemedicine holds significant potential to improve ED triage and care in non-critical cases, reducing waiting times and enhancing patient outcomes. Further research is needed to establish its efficacy in high-acuity settings and address challenges related to infrastructure and privacy. Telemedicine should complement in-person care as part of an integrated ED strategy.