1) A teletrauma network was established to connect rural emergency departments with level 1 trauma centers using telemedicine to improve access to specialist care. 2) In phase 1, 4 rural hospitals were connected to 1 trauma center, showing positive user attitudes and increased effectiveness. Clinical outcomes like evaluation ease and overall satisfaction improved. 3) Phase 2 will expand the network to include 2 additional trauma centers, a pediatric center, and 18 rural hospitals to further standardize the process and evaluate outcomes across multiple sites.

1. Teletrauma: Putting it all Together
Rich Bias, Sr. VP MCG Health
Debra Kitchens, RN, Trauma Program Manager MCCG
Cyndie Roberson, RN, Director of Patient Intake, CHOA

2. Background and Significance
Disparities exist in trauma morbidity and mortality based on a
rural or urban care setting
The relative risk of a rural victim dying in a motor vehicle crash is
15 times higher than in urban areas
Injury related deaths are 40% higher in rural communities
87% of rural pediatric traumas do not survive to reach the
hospital

3. Rural ED
Solution:
Rural ED
Teletrauma Network
Level I
Rural ED Trauma Center
• Program began July 2009
• Goal – to enable rural emergency department practitioners
and trauma patients access to a team of surgeons and
specialists at a Level I Trauma Center
• Innovative and cutting edge technology used to save lives,
increase efficiency, and improve the level of care

4. Phase I
Region V: Trauma Center Medical Center of Central
Georgia
Rural Partners
Dodge County Hospital
Fairview Park Hospital
Peach Regional Medical
Center
Taylor Regional Hospital

5. Advantages to Teletrauma Network
• Enable rural trauma team to
virtually add a trauma specialist to
their response team
• Utilizes real-time visual link which
greatly enhances the trauma
specialists ability to participate in
care
• Improved communication, improve
continuum of care
• Improve relationships between
health care providers
• Aid in the initial evaluation, treatment, and care of the
patients which can improve outcomes and reduce cost

6. Results from Phase I
• Positive attitude toward use of the telemedicine system
• 73% indicated that using telemedicine is a good idea
• 80% reported that using telemedicine is a positive step
• 87% reported they plan to use telemedicine for trauma in
the future
• 53% noted that using telemedicine increases their
effectiveness
• 58% found system useful in their jobs
• Clinical Outcomes
• 67% reported using system
makes it easier to evaluate
patients
• Overall satisfaction was
reported to be 69%

7. Moving Forward
Phase II: 2 additional Level I Trauma Centers, 1 Pediatric Specialty
Center
and 18 Rural Hospitals
MCG Health, Inc Memorial Health University Children's Healthcare of
Medical Center Atlanta
• Emanuel Medical • Jeff Davis Hospital
Center • Bacon County Hospital • Habersham County Medical
• Washington County • Effingham County Hospital
Center
Regional Medical • Satilla Regional Medical
• Chatuge Regional Hospital
Center Center • Miller County Hospital
• Burke Medical Center • Coffee Regional Medical
• Jefferson Hospital Center
• McDuffie Regional
Medical Center

8. Phase II Process and
Implementation
Identification of Rural Partners
• Transfer patterns to Trauma Centers
Credentialing
• By Proxy Credentialing
Training/Inservice
• Basic Inservice
• Advanced end to end process testing
Process Go Live
• Trauma Physician availability 24/7

9. Telemedicine Process and Flow
Enhanced access to specialty consultation
Through enhanced resources
Patient Arrival in Rural Emergency Room physician collaboration increases
the likelihood of a positive
Notification to Level I trauma Center
outcome
• ATLS stabilization and transport
guidelines and principles can be
Collaborative Evaluation through telemedicine enhanced primary and directed by the trauma surgeon
secondary survey
• Mutual decisions for patient
Synergistic determination for treatment plan and patient disposition
disposition ensure the most
efficient use of resources without
compromising outcome
Evaluation and Outcome
.
Patient transferred to Level I
Patient remains at local hospital for
Trauma Center for further
care
evaluation and treatment

10. Phase II Evaluation
• Use of a standardized process will allows comparison of outcomes for all sites
• Additional component added to determine perceptions influencing intentions of trauma
and emergency team members to support the use of a telemedicine system for trauma
• Specific Questions:
• What are the perceptions of trauma and emergency team members about the use of a
telemdicine system for trauma
• What are the relationships between pre and post implementation perceptions and intentions to
support the use of a telemedicine system for trauma
• What effect did the use of a telemedicine system have on the number of transfers to the Level I
trauma center

11. Based on the outcomes from Phase I and Phase II of
the project next steps will be determined.
The goal is to be able to provide telemedicine services
for trauma care throughout the state of Georgia
Questions ?