{"doi":"10.1101/2023.08.09.23293892","title":"The effect of sepsis recognition on telemedicine use and bundle completion in rural emergency department sepsis treatment","abstract":"ABSTRACT Purpose Provider-to-provider emergency department telehealth (tele-ED) has been proposed to improve rural sepsis care. The objective of this study was to measure the association between sepsis documentation and tele-ED use, treatment guideline adherence, and mortality. Materials and Methods This analysis was a multicenter (n=23) cohort study of sepsis patients treated in rural emergency departments (EDs) that participated in a tele-ED network between August 2016 and June 2019. The primary exposure was whether sepsis was recognized in the local ED, and the primary outcome was rural tele-ED use, with secondary outcomes of time to tele-ED use, 3-hour guideline adherence, and in-hospital mortality. Results Data from 1,146 rural sepsis patients were included, 315 (27%) had tele-ED used, and 415 (36%) had sepsis recognized in the rural ED. Sepsis recognition was not independently associated with higher rates of tele-ED use (adjusted odds ratio [aOR] 1.23, 95% CI 0.90–1.67). Sepsis recognition was associated with earlier tele-ED activation (adjusted hazard ratio [aHR] 1.69, 95% CI 1.34-2.13), lower 3-hour guideline adherence (aOR 0.73, 95% CI: 0.55-0.97), and lower in-hospital mortality (aOR 0.72, 95% CI: 0.54-0.97). Conclusions Sepsis recognition in rural EDs participating in a tele-ED network was not associated with tele-ED use.","journal":"medRxiv","year":2023,"id":394953,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9012,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1114464,"name":"J. Priyanka Vakkalanka","orcid":"0000-0002-6419-3433","position":1,"is_corresponding":false},{"id":914032,"name":"Uche Okoro","orcid":null,"position":2,"is_corresponding":false},{"id":914034,"name":"Cole Wymore","orcid":null,"position":3,"is_corresponding":false},{"id":411328,"name":"Karisa K. Harland","orcid":"0000-0001-9482-8447","position":4,"is_corresponding":false},{"id":914033,"name":"Kalyn Campbell","orcid":null,"position":5,"is_corresponding":false},{"id":411350,"name":"Morgan B. Swanson","orcid":"0000-0003-0558-4191","position":6,"is_corresponding":false},{"id":512233,"name":"Brian M. Fuller","orcid":"0000-0003-3757-756X","position":7,"is_corresponding":false},{"id":411338,"name":"Brett Faine","orcid":"0000-0002-5759-9857","position":8,"is_corresponding":false},{"id":616163,"name":"Anne Zepeski","orcid":"0000-0001-6309-6554","position":9,"is_corresponding":false},{"id":654392,"name":"Edith A. Parker","orcid":null,"position":10,"is_corresponding":false},{"id":913510,"name":"Luke Mack","orcid":"0000-0003-1253-8257","position":11,"is_corresponding":false},{"id":913511,"name":"Amanda Bell","orcid":"0000-0002-9920-565X","position":12,"is_corresponding":false},{"id":914035,"name":"Katie DeJong","orcid":null,"position":13,"is_corresponding":false},{"id":412581,"name":"Kelli Wallace","orcid":null,"position":14,"is_corresponding":false},{"id":913512,"name":"Keith J. Mueller","orcid":"0000-0002-6533-3303","position":15,"is_corresponding":false},{"id":610824,"name":"Elizabeth A. Chrischilles","orcid":"0000-0002-1843-1955","position":16,"is_corresponding":false},{"id":512237,"name":"Christopher R. Carpenter","orcid":"0000-0002-2603-7157","position":17,"is_corresponding":false},{"id":1169777,"name":"Michael P. Jones","orcid":"0000-0002-8377-5383","position":18,"is_corresponding":false},{"id":455383,"name":"Marcia M. Ward","orcid":"0000-0003-1948-1302","position":19,"is_corresponding":false},{"id":411327,"name":"Nicholas M. Mohr","orcid":"0000-0003-0497-5828","position":20,"is_corresponding":false},{"id":826292,"name":"Anna M. Kaldjian","orcid":"0000-0001-9313-9295","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T01:19:18.686170Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}