OBJECTIVES/SPECIFIC AIMS: This study will elucidate what percent of unnecessary ED visits for chronic conditions can be reduced by extant telemedicine devices, and which telemedicine devices can yield the greatest reduction in unnecessary ED visits for chronic conditions. METHODS/STUDY POPULATION: We intend to use the Nationwide Emergency Department Sample (NEDS) to estimate the percent of ED visits, with a chronic condition as the principal diagnosis, were only evaluation and management services were rendered. The NEDS is the largest publicly available, all-payer ED database, providing national estimates of ED visits. The NEDS contains information on patient demographics, principal diagnosis (captured by ICD-9-CM codes and defined as the main reason for bringing the patient to the hospital), and procedure codes using Current Procedural Terminology, Fourth Edition (CPT-4). Patients with a chronic condition will be identified using Chronic Condition Indicator developed by the Agency for Healthcare Research and Quality and, from them, patients who only received “evaluation and management” services will be extracted using the CPT-4 codes 99281–99283 and G0380–G0383. Then using our previously developed database, wherein FDA-approved OTC medical devices were allied to chronic conditions by applying the transitive property of equality between telemedicine devices – measurement and measurement – conditions pairs, we will elucidate what percent of unnecessary ED visits for chronic conditions which can be reduced by extant telemedicine devices. RESULTS/ANTICIPATED RESULTS: We anticipate multiple OTC telemedicine devices will be necessary to evaluate and manage common principal conditions. DISCUSSION/SIGNIFICANCE OF IMPACT: Telemedicine is seen as a potentially powerful tool for improving healthcare and reducing cost. UnitedHealthcare, the largest US insurance provider, has partnered with Doctors on Demand, the largest players in the telemedicine app space, and other app-based telemedicine services to provide on-demand access to physicians. However, to reach the full potential of telemedicine, and more specifically towards reducing unnecessary ED visits for chronic conditions, telemedicine services need to include capabilities that will allow for the evaluation and management of chronic conditions. This study is a pragmatic first step towards understanding what telemedicine devices would best augment existing telemedicine services to reduce unnecessary ED utilization.
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机译：目标/特定目的：这项研究将阐明现有的远程医疗设备可以减少慢性病不必要的ED就诊的百分比，以及哪种远程医疗设备可以最大程度地减少慢性病不必要的ED就诊。方法/研究人群：我们打算使用全国急诊科样本（NEDS）来评估仅以评估和管理服务为基础的以慢性病为主要诊断的急诊就诊的百分比。 NEDS是最大的可公开获得的，全额付款的ED数据库，可提供全国对ED访问的估计。 NEDS包含有关患者人口统计信息，主要诊断（由ICD-9-CM编码捕获并定义为将患者送往医院的主要原因）的信息，以及使用《现行程序术语》第四版（CPT-4）编写的程序代码。慢性病患者将使用由美国医疗保健研究与质量局开发的慢性病指标来识别，从他们中，仅接受“评估和管理”服务的患者将使用CPT-4代码99281–99283和G0380进行提取–G0383。然后，使用我们先前开发的数据库，其中通过应用远程医疗设备之间相等性的传递特性（测量和测量-条件对），将FDA批准的OTC医疗设备与慢性疾病相关联，我们将阐明针对慢性病的不必要ED访视的百分比可以通过现有的远程医疗设备来减少。结果/预期结果：我们预计需要多种OTC远程医疗设备来评估和管理常见的主要疾病。讨论/意义深远：远程医疗被认为是改善医疗保健和降低成本的潜在强大工具。美国最大的保险提供商UnitedHealthcare已与远程医疗应用程序领域最大的参与者Doctors on Demand和其他基于应用程序的远程医疗服务建立了合作关系，以按需访问医生。但是，为了充分发挥远程医疗的潜力，更具体地说，是为了减少针对慢性病的不必要的急诊就诊，远程医疗服务需要包括能够评估和管理慢性病的功能。这项研究是务实的第一步，旨在了解哪种远程医疗设备将最好地增强现有的远程医疗服务，以减少不必要的ED利用率。
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