The ACTUATE-CBC Study: Accelerating The Uptake of Telemedicine for Crisis Burn Care

Abstract

During a crisis, the United States will struggle to meet the clinical care needs of burn patients. Very few clinicians (1% of nurses and physicians) and few hospitals (2%) have burn care expertise. Due to these capacity limitations, patients with burns as large as 40% total body surface area will have to remain in care locations without burn expertise for days to weeks in a burn crisis. Telemedicine is an effective way to connect a caregiver in any location to a burn clinician, however, under all circumstances it remains underused. Burn teleconsultation reduces over resuscitation, improves the accuracy of the burn diagnosis, improves communication among providers, and results in fewer unnecessary patient transfers. Given this compelling evidence, it is unclear why it is not used more often. Our proposal directly aligns with the FY20 MBRP Focus Area #2 - Burn care solutions for use by the medical first responder in the pre-hospital setting (not necessarily in a PFC scenario). We conceptualize pre-hospital in this study as pre burn center care, and we propose that providing evidence to support an ongoing, intermittent whole team burn teleconsultation model for the prolonged field care or civilian crisis care situation is the solution. Objective and Hypotheses: Implementation science seeks to uncover the factors affecting the use of evidence based practices like burn teleconsultation. Our research objective is to develop and test the effectiveness of a burn teleconsultation implementation intervention that will accelerate its uptake. We hypothesize that clinician ratings of acceptability, feasibility, and intention to use teleconsultation will relate to its actual use, and that deployment of the toolkit will change clinicians perceptions and intention to use it under usual care and during a crisis.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2022
Accession Number
AD1194109

Entities

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  • Amanda Bettencourt

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  • University of Pennsylvania

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  • Medicine

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  • Medical or Health Care Field.
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  • Trauma Surgery or Emergency Medicine.