The primary purpose of this project was to routinely collect data from the grantees using the revised Tele-Emergency Performance Assessment Reporting Tool, perform regular quality checks and data management activities, increase the telehealth sample size using a targeted intervention, and begin descriptive statistical analysis.

The project: 1) collected retrospective and prospective data on the uniform set of measures from the six Evidence-Based Telehealth Network Grant Program grantees based on the established procedures and protocols (from Projects 1A and 1B in Year 1); 2) reviewed and provided feedback on the quality of data, and worked through data collection issues; 3) identified the expected extent of data collection periods based on the number of tele-ED encounters reported and desired power; 4) developed and implemented a targeted plan for increasing telehealth consultation for rural sepsis patients; 5) performed periodic descriptive statistical analysis to identify the ability to address the research questions; 6) developed procedures for identifying and collecting data on the uniform set of measures from an appropriate comparison group that did not utilize tele-ED; 7) developed a research analysis plan specifying the appropriate analytical approaches and statistical methods that could be used to answer priority research questions based on the collected data; and 8) mapped out manuscript writing plans.

Publications

• Improving Access to High Quality Sepsis Care in a South Dakota Emergency Telemedicine Network
  Policy Brief
  Rural Telehealth Research Center
  Date: 08/2017
  This brief describes an implementation initiative designed to increase use of emergency department-based telemedicine consultation for patients with severe sepsis or septic shock. This initiative is the first step of an analysis to estimate the effect of telemedicine on sepsis care and outcomes.
• Serum Anion Gap Predicts Lactate Poorly, but May Be Used to Identify Sepsis Patients at Risk for Death: A Cohort Study
  Journal Article
  Rural Telehealth Research Center
  Date: 04/2018
  Our study of 4,159 emergency department patients determined anion gap and serum bicarbonate poorly predict changes in lactate and mortality. In resource-limited settings where lactate is unavailable, anion gap ≥ 20 mEq/L may be used to further risk-stratify patients for ongoing sepsis care, but lactate remains a preferred biomarker.