title: Expediting Time from Symptoms to Medical Contact Utilizing a Telemedicine Call Center.
abstract: BACKGROUND
  No definitive solution has been forthcoming for the often dangerously long interval between symptom onset and seeking medical care in the prehospital setting. We examined the implementation of telemedicine technology and characterization of its utilizers for its efficacy in reducing this possibly life-threatening time lag.
  
  
  METHODS
  A retrospective observational study was performed on the working database of an operational telemedicine facility that included all subscribers. Time-to-contact measurements throughout 2012 were retrieved from its medical files, and data on age, gender, medical history, and main complaint were analyzed.
  
  
  RESULTS
  Throughout 2012, 22,274 of a total of 46,556 calls (47.8%) were made ≤60 min from symptom onset. It is important that 26.9% of all calls (12,522/46,556) were made in <15 min. Significantly more males (10,794/22,229 [49%]) contacted in ≤60 min compared with females (11,480/24,327 [47%], p<0.03). Subjects <60 years of age (2,889/5,717 [51%]) called earlier than those >60 years (19,386/40,839 [47%], p<0.001). Patients with prior resuscitation and/or myocardial infarction contacted significantly more rapidly than those with other cardiac diseases. Over one-half of patients with cardiac complaints contacted the call center ≤60 min from symptom onset, as did those who suffered physical trauma, but not patients with gastrointestinal symptoms or pain elsewhere.
  
  
  CONCLUSIONS
  A telemedicine system with rapid accessibility to a professional call center and prompt triage thereafter could be an additional promising strategy for shortening the interval between symptom onset and call for medical assistance. Implementation of a widespread telemedicine infrastructure may bridge the unmet gap between occurrence of symptoms to initiation of medical treatment.
authors.affiliation: 1 Department of Cardiology, Tel Aviv Sourasky Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Eran
authors.initials: E
authors.lastname: Leshem-Rubinow
authors.affiliation: 1 Department of Cardiology, Tel Aviv Sourasky Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Eyal Ben
authors.initials: EB
authors.lastname: Assa
authors.affiliation: 1 Department of Cardiology, Tel Aviv Sourasky Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Yacov
authors.initials: Y
authors.lastname: Shacham
authors.affiliation: 2 'SHL'-Telemedicine, Israel, Tel Aviv, Israel .
authors.forename: Avivit
authors.initials: A
authors.lastname: Zatelman
authors.affiliation: 2 'SHL'-Telemedicine, Israel, Tel Aviv, Israel .
authors.forename: Ayelet
authors.initials: A
authors.lastname: Oren-Shamir
authors.affiliation: 2 'SHL'-Telemedicine, Israel, Tel Aviv, Israel .
authors.forename: Nomi
authors.initials: N
authors.lastname: Malov
authors.affiliation: 2 'SHL'-Telemedicine, Israel, Tel Aviv, Israel .
authors.forename: Michal
authors.initials: M
authors.lastname: Golovner
authors.affiliation: 1 Department of Cardiology, Tel Aviv Sourasky Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Arie
authors.initials: A
authors.lastname: Roth
mesh_terms: D000328:Adult; D000368:Aged; D000070456:Call Centers; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012648:Self Care / Q000379:methods*; D017216:Telemedicine / Q000379:methods*; D013997:Time Factors
keywords: prehospital care; telemedicine; time from symptoms