A Systematic Review of Telemedicine Applications and Outcomes in Emergency Department Settings

Abstract

Background: Telemedicine has emerged as a strategic tool to address emergency department (ED) overcrowding and operational challenges, particularly following accelerated adoption during the COVID-19 pandemic. Aim: This systematic review synthesizes recent evidence on telemedicine applications and outcomes in ED settings, following PRISMA guidelines. Methods: Twelve studies were included, encompassing diverse designs (e.g., simulation trials, observational studies, qualitative interviews) and geographies. Results: Findings highlight three key themes: (1) telemedicine as an operational tool to improve patient flow, with evidence supporting its role in reducing low-acuity ED visits and optimizing resource use; (2) telemedicine as a means to enhance care processes, with high user satisfaction among patients and providers, though dependent on training and workflow-integrated design; and (3) telemedicine as a platform for innovation, including augmented reality and artificial intelligence for advanced diagnostics and consultation. Conclusion: While telemedicine demonstrates promise in improving efficiency and access, the evidence remains heterogeneous, with a need for more randomized controlled trials focusing on clinical outcomes. Future implementation must address sustainability, equity, and integration into health systems to realize telemedicine’s potential in reshaping emergency care.