In this paper, a new method is presented to study the impacts of telemedicine on the performance of an emergency department in Spain. Spain’s Demographics indicate that this country is experiencing population aging, resulting in overcrowding of emergency departments and significant demand on the healthcare system. However, it has been reported that most patients visiting emergency departments are not in an urgent clinical condition, thus they causing hospital overcrowding, high medical expenses, delays in clinical service delivery and low service efficiency for urgent patients who truly need emergency care. Telemedicine and e-health are considered as solutions for remote delivery of health services to care seekers in order to decrease hospital visits for patients who are in less of an emergency condition. In this study, by using detailed computational modeling and clinical data, we have investigated the impacts of telemedicine on the performance of an emergency department through estimations of Length of Stay as a quantitative index for evaluation of quality of service in the emergency department. Specifically, an agent-based modeling and simulation system was developed and used to study the behavior of the emergency department by taking detailed modeling parameters, including varying the number of non-urgent arrivals as a result of telemedicine, into account as inputs of the model. The inputs were provided through collection and analysis of clinical data that enabled us to predict how telemedicine changes emergency department visits. Our results indicated that emergency departments would experience decreases equal to 41.14% in total Length of Stay if eliminating all non-urgent visits and decreases of up to 10.48% if restricting the non-urgent visits. The developed computational tool in this study and the corresponding results obtained can provide decision makers and health care providers with objective information on the impacts of e-health services on the efficiency of emergency department and they can have also implications for care delivery, optimizing resources, planning, and improving the quality of care.

中文翻译：

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通过减少西班牙的非紧急患者调查远程医疗对急诊科的影响

在本文中，提出了一种新方法来研究远程医疗对西班牙急诊科绩效的影响。西班牙的人口统计数据表明，该国正在经历人口老龄化，导致急诊室人满为患，对医疗系统的需求巨大。然而，据报道，大多数就诊的急诊患者并非处于紧急临床状态，导致医院人满为患，医疗费用高，临床服务延迟，对真正需要急诊的急诊患者的服务效率低下。远程医疗和电子医疗被认为是向寻求护理者提供远程医疗服务的解决方案，以减少紧急情况较轻的患者的就诊次数。在这项研究中，通过使用详细的计算模型和临床数据，我们通过估计住院时间作为评估急诊科服务质量的量化指标，研究了远程医疗对急诊科绩效的影响。具体来说，开发了一个基于代理的建模和模拟系统，并通过将详细的建模参数（包括远程医疗导致的非紧急到达次数的变化）作为模型的输入来研究急诊科的行为. 这些输入是通过收集和分析临床数据提供的，使我们能够预测远程医疗如何改变急诊科就诊。我们的结果表明，急诊科的人数将减少 41。如果取消所有非紧急访问，则总逗留时间为 14%，如果限制非紧急访问，则减少最多 10.48%。本研究中开发的计算工具和获得的相应结果可以为决策者和卫生保健提供者提供有关电子卫生服务对急诊科效率影响的客观信息，它们也可以对护理提供、优化资源、计划和提高护理质量。