TELEMEDICINE APPLICATIONS IN PREHOSPITAL EMERGENCY CARE: A BIBLIOMETRIC ANALYSIS

Öz

Background: The integration of telemedicine technologies into prehospital emergency care represents a significant development in healthcare delivery. Objective: To systematically analyze publication patterns, technology focus areas, and research trends in telemedicine applications in prehospital emergency care between 2019 and 2022. Methods: A comprehensive bibliometric analysis was conducted following PRISMA 2020 guidelines. Five electronic databases (PubMed, CINAHL, Embase, Web of Science, and Scopus) were systematically searched for studies published between January 1, 2019, and December 31, 2022. Only English-language publications, including original research articles, reviews, and meta-analyses, were included. Bibliometric analyses and network visualizations were performed using Bibliometrix (R-package) and VOSviewer. Results: A total of 198 publications were included, demonstrating substantial growth with a compound annual growth rate of 32.4%. Mobile health applications were the most prominent research area (44.9%), followed by remote monitoring systems (33.8%) and artificial intelligence applications (27.3%). North American institutions accounted for the largest share of research output (48.0%). Technical challenges (33.8%) and regulatory issues (27.3%) were identified as the most frequently reported implementation barriers. Conclusions: Telemedicine research in prehospital emergency care has expanded considerably, with increasing emphasis on mobile health applications, artificial intelligence, and remote monitoring systems. These findings provide an overview of the current research landscape and may inform future investigations in this field.

Anahtar Kelimeler

• Telemedicine
• Prehospital emergency care
• Emergency medical services
• Mobile health
• Bibliometric analysis

Kaynakça

1. 1. Winburn AS, Brixey JJ, Langabeer J, Champagne-Langabeer T. A systematic review of prehospital telehealth utilization. J Telemed Telecare. 2018;24(7):473–481.
2. 2. World Health Organization. Telemedicine: opportunities and developments in Member States: report on the second global survey on eHealth. Geneva: World Health Organization; 2010.
3. 3. Amadi-Obi A, Gilligan P, Owens N, O'Donnell C. Telemedicine in pre-hospital care: a review of telemedicine applications in the pre-hospital environment. Int J Emerg Med. 2014; 7:29.
4. 4. Chan J, Griffith LE, Costa AP, Leyenaar MS, Agarwal G. Community paramedicine: a systematic review of program descriptions and training. CJEM. 2019;21(6):749–761.
5. 5. Brown D, Greer N, Guzzetta CE, Hulett M, Wilt TJ. Decision support capabilities of telemedicine in emergency prehospital care: systematic review. J Med Internet Res. 2020;22(12): e18959.
6. 6. Ward MM, Jaana M, Natafgi N. Systematic review of telemedicine applications in emergency care. Int J Med Inform. 2015;84(9):601–616.
7. 7. Quadflieg LTM, Beckers SK, Bergrath S, et al. Comparing the diagnostic concordance of tele-EMS and on-site EMS physicians: a retrospective cohort study. Sci Rep. 2020;10(1):17982.
8. 8. Adibhatla S, Lurie T, Betz G, et al. A systematic review of methodologies and outcome measures of mobile integrated health–community paramedicine programs. Prehosp Emerg Care. 2024;28(1):168–178.

9. 9. Bukowski K, Swiatek-Barylska I, Jarosinska D, Kapala A. Telemedicine in emergency medicine in the COVID-19 pandemic: experiences and prospects. Healthcare (Basel). 2022;10(7):1163.
10. 10. Snoswell CL, Chelberg G, De Guzman KR, et al. The clinical effectiveness of telehealth: a systematic review of meta-analyses. J Telemed Telecare. 2021;27(10):605–624.
11. 11. Donthu N, Kumar S, Mukherjee D, Pandey N, Lim WM. How to conduct a bibliometric analysis: an overview and guidelines. J Bus Res. 2021; 133:285–296.
12. 12. Koo J, Lin Y. An analysis of reporting practices in the top 100 cited bibliometric studies. Scientometrics. 2023;128: 2901–2920.
13. 13. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372: n71.
14. 14. Aria M, Cuccurullo C. Bibliometrix: an R-tool for comprehensive science mapping analysis. J Informetr. 2017;11(4):959–975.
15. 15. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. 2018;24(1):4–12.
16. 16. Passas I. Bibliometric analysis: the main steps. Encyclopedia. 2024;4(2):1014–1025.
17. 17. Raza MH, Alshamrani M, Bano A. Recent advances on IoT-assisted wearable sensor systems for healthcare monitoring. Biosensors (Basel). 2021;11(10):372.
18. 18. Zupic I, Čater T. Bibliometric methods in management and organization. Organ Res Methods. 2015;18(3):429–472.
19. 19. Schröder H, Beckers SK, Borgs C, et al. Long-term effects of a prehospital telemedicine system on structural and process quality indicators. Sci Rep. 2024;14(1):310.
20. 20. Ong MEH, Ho AFW, Yap S, et al. Artificial intelligence in prehospital emergency care: opportunities and challenges. Emerg Med J. 2021;38(10):785–789.
21. 21. Plaza Roncero A, Marques G, Sainz-De-Abajo B, et al. Mobile health apps for medical emergencies: systematic review. JMIR Mhealth Uhealth. 2020;8(12):e18513.
22. 22. Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, et al. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013;10(1):e1001363.
23. 23. Tsao YC, Cheng FJ, Li YH, Liao LD. An IoT-based system for patient monitoring in prehospital care. Emerg Med Int. 2022; 2022: 7245650.
24. 24. Ng WL, Ong SY, Tan CJ, et al. Artificial intelligence in prehospital emergency care: a scoping review. iScience. 2023;26(8):107407.
25. 25. Clark M, Severn M. Artificial intelligence in prehospital emergency health care. Ottawa (ON): CADTH; 2023.
26. 26. Lurie T, Adibhatla S, Betz G, et al. Mobile integrated health–community paramedicine programs' effect on emergency department visits: an exploratory meta-analysis. Am J Emerg Med. 2023; 66:1–10.
27. 27. Kang H, Park HA, Jung SY, Kim J. Telemedicine adoption during the COVID-19 pandemic: gaps and inequalities. Appl Clin Inform. 2021;12(4):836–844.
28. 28. Keesara S, Jonas A, Schulman K. Covid-19 and health care’s digital revolution. N Engl J Med. 2020;382: e82.
29. 29. Robie S, Dalrymple JL, Engel M, et al. The state of telehealth before and after the COVID-19 pandemic. Prim Care. 2022;49(4):517–530.