Virtual Triage and Follow-Up: Systematic Review of Telehealth Interventions Closing the Emergency Department to Home Gap

Abstract

Background: Transitions of care from the Emergency Department (ED) to home are a vulnerable, high-risk period for patients with high adverse event rates, medication errors, and unplanned reutilization of the health service. Traditional methods of discharge are often hindered by time constraints, information overload, and communication breakdowns, leaving patients and caregivers insufficiently equipped to care for themselves after discharge.

Aim: This systematic review consolidates the current evidence on the implementation, effectiveness, and sustainability of virtual triage and follow-up nursing interventions. The interventions use telehealth, in the form of video post-discharge calls by ED nurses, to track wound healing, assess medication knowledge, verify follow-up primary care visits, and refer clinical problems as indicated.

Methods: Systematic search of literature using PubMed, CINAHL, Scopus, and Web of Science between 2010 and 2024 for publications. The keywords utilized were "telehealth," "telenursing," "post-discharge," "emergency department," "transition of care," "video follow-up," "care gap," and "remote patient monitoring." Studies were eligible if they depicted a nurse-administered telehealth intervention in ED discharge patients and had outcome measurements like ED revisit rates, patient satisfaction, medication adherence, or follow-up appointment attendance.

Results: Invariably across the 40 studies and reports considered, virtual nursing follow-up emerges as a feasible and extremely effective intervention. Key findings are marked reductions in 7-day and 30-day ED revisit rates with risk reductions ranging from 15% to 42%. Intervention arm patient satisfaction scores and quality of care scores were significantly higher compared to usual care. Moreover, these interventions led to improved medication adherence (up to 35% increase), wound care compliance, and primary care provider linkages. Common operational challenges were hindrances to technology access, incorporation in nurse workflow, and reimbursement models.

Conclusion: Virtual nursing triage and follow-up is an innovative model that effectively bridges the ED-home care gap. Through providing timely, anticipatory, and patient-centered care, this intervention ensures patient safety, improves critical clinical outcomes, and prevents unnecessary healthcare utilization. To effectively spread, future efforts should prioritize the development of standard protocols, securing sustainable financing, and digital equity to ensure that all patients can benefit from this innovative process of care transition.