Trial Outcomes & Findings for Prehospital Telemedicine Feasibility/Acceptability Pilot (NCT NCT05967624)

NCT ID: NCT05967624

Last Updated: 2026-02-19

Results Overview

Each subject will be remotely assessed by a Medical Control Physician using the HIPAA-compliant Zoom Pro web application pre-loaded on a tablet device. The remote medical control physician and the transport team member at the patient bedside in the ambulance will score the Respiratory Observation Checklist simultaneously. The range for agreement is 0 to 1.0, where 0=no agreement and 1 is perfect agreement. The following scale: 0.01-0.20=none to slight, 0.21-0.40=fair, 0.41-0.60=moderate, 0.61-0.80=substantial, 0.81-1.0=almost perfect agreement will be used.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 20 participants
• Primary outcome timeframe: During transport to the hospital via ambulance, up to 4 hours
• Results posted on: 2026-02-19

Participant Flow

Participant milestones

Measure	Teleconsultation Group Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Overall Study STARTED	20
Overall Study COMPLETED	20
Overall Study NOT COMPLETED	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Prehospital Telemedicine Feasibility/Acceptability Pilot

Baseline characteristics by cohort

Measure	Teleconsultation Group n=20 Participants Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Age, Continuous	0.9 years n=4 Participants
Sex: Female, Male Female	7 Participants n=4 Participants
Sex: Female, Male Male	13 Participants n=4 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	5 Participants n=4 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	15 Participants n=4 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=4 Participants
Race/Ethnicity, Customized White	15 Participants n=4 Participants
Race/Ethnicity, Customized Black or African American	1 Participants n=4 Participants
Race/Ethnicity, Customized Asian	1 Participants n=4 Participants
Race/Ethnicity, Customized Unknown or Not Reported	3 Participants n=4 Participants
Region of Enrollment United States	20 Participants n=4 Participants

PRIMARY outcome

Timeframe: During transport to the hospital via ambulance, up to 4 hours

Population: Two calls did not connect so the overall number analyzed is 18.

Each subject will be remotely assessed by a Medical Control Physician using the HIPAA-compliant Zoom Pro web application pre-loaded on a tablet device. The remote medical control physician and the transport team member at the patient bedside in the ambulance will score the Respiratory Observation Checklist simultaneously. The range for agreement is 0 to 1.0, where 0=no agreement and 1 is perfect agreement. The following scale: 0.01-0.20=none to slight, 0.21-0.40=fair, 0.41-0.60=moderate, 0.61-0.80=substantial, 0.81-1.0=almost perfect agreement will be used.

Outcome measures

Measure

Teleconsultation Group n=18 Participants Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.

Agreement in Assessment of Respiratory Distress

0.83 proportion agreement Interval 0.58 to 0.96

SECONDARY outcome

Timeframe: Immediately after the transport was completed, up to 48 hours

Population: There were 3 transport nurses and 2 physicians and the scores represent an average of the 20 ambulance encounters.

The total usability score is measured by the Telehealth Usability Questionnaire (TUQ), a 21-item questionnaire which is a validated measure of all the key usability characteristics of telehealth platforms (usefulness, ease of use, effectiveness, reliability, and satisfaction). Users [transport nurses and physicians] rate items on 7-point Likert-scales (1=disagree to 7=agree) in 6 separate domains (usefulness, ease of use and learnability, interface quality, interaction quality, reliability, satisfaction and future use). The investigators modified this questionnaire to specifically address the usability of the study telemedicine platform. The range of the total usability score is 1-7. Low scores reflect a worse outcome, while high scores are a better outcome.

Outcome measures

Measure	Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Total Usability Score Nurses	6 score on a scale Standard Deviation 0.9
Total Usability Score Physicians	5.7 score on a scale Standard Deviation 0.7

SECONDARY outcome

Timeframe: Immediately after the transport was completed, up to 48 hours

Population: There were 3 transport nurses and 2 physicians and the scores represent an average of the 20 ambulance encounters.

This will be measured by TUQ items #11 and #14 within the "Interaction Quality" domain. Users [transport nurses and physicians] will rate each item on a 7-point Likert-scale (1=disagree to 7=agree), so scores will range from 1 to 7. The mean score and standard deviation (SD) for each item will be reported. Higher scores suggest higher quality.

Outcome measures

Measure	Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Video Quality Nurses- "I could easily talk to the patient/clinician using the telemedicine system."	6.6 units on a scale Standard Deviation 0.8
Video Quality Physicians- "I could easily talk to the patient/clinician using the telemedicine system".	6.2 units on a scale Standard Deviation 0.8
Video Quality Nurses- "Using the telemedicine system, I can see the patient/clinician as if we met in person."	6.2 units on a scale Standard Deviation 1.3
Video Quality Physicians- "Using the telemedicine system, I can see the patient/clinician as if we met in person."	3.9 units on a scale Standard Deviation 1.3

SECONDARY outcome

Timeframe: immediately after the transport was completed, up to 48 hours

Population: There were 3 transport nurses and 2 physicians and the scores represent an average of the 20 ambulance encounters.

This will be measured by TUQ items #12 and #13 within the "Interaction Quality" domain. Users [transport nurses and physicians] will rate each item on a 7-point Likert-scale (1=disagree to 7=agree), so scores will range from 1 to 7. The mean score and SD for each item will be reported. Higher scores suggest higher quality.

Outcome measures

Measure	Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Audio Quality Nurses- "I could hear the patient/clinician easily using the telemedicine system."	6.3 units on a scale Standard Deviation 1.2
Audio Quality Physicians- "I could hear the patient/clinician easily using the telemedicine system."	6.2 units on a scale Standard Deviation 0.9
Audio Quality Nurses- "I felt I was able to express myself effectively."	6.9 units on a scale Standard Deviation 0.3
Audio Quality Physicians- "I felt I was able to express myself effectively."	6.1 units on a scale Standard Deviation 0.8

SECONDARY outcome

Timeframe: immediately after the transport was completed, up to 48 hours

The number of attempts transport team providers make to successfully connect with the medical control physician via video-call will be recorded. Adequacy of successful video-call connection is defined as ≤2 attempts to achieve a video-call connection.

Outcome measures

Measure	Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Adequacy of Successful Video-call Connections Adequate (≤2 attempts)	14 encounters
Adequacy of Successful Video-call Connections Inadequate (>2 attempts)	6 encounters

SECONDARY outcome

Timeframe: Success/failure was assessed during transport, up to 4 hours

Study investigators will note any problems with tablet mounts in the ambulance cabin (e.g., location makes call activation difficult), as well as specific qualitative comments from participants regarding tablet mount strategy. If no problems are noted the tablet mount will be considered successful and the percentage of successful table mounts will be reported.

Outcome measures

Measure	Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Percentage of Successful Tablet Mounts Successful	100 percentage of mounts
Percentage of Successful Tablet Mounts Not successful	0 percentage of mounts

SECONDARY outcome

Timeframe: during ambulance transport, up to 4 hours

This will be measured as the proportion of video-calls where clinicians are able to observe all ten items on the Respiratory Observation Checklist. This checklist tool has been previously validated for rapid, reliable assessment of children by teleconsultants in emergency settings. Medical control physicians will score 9 observable signs and a global assessment of respiratory distress dichotomously (present/absent).

Outcome measures

Measure	Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.
Percentage of Calls With Adequate Video Quality for Assessment Optimal video quality for assessment	33.3 percentage of video quality
Percentage of Calls With Adequate Video Quality for Assessment Video quality not optimal for assessment	66.7 percentage of video quality

SECONDARY outcome

Timeframe: up to 240 minutes

This is the time interval (minutes) from when BCH receives the patient transport request from the referring facility to the time the transport team arrives at the referring facility. This will be abstracted from transport records.

Outcome measures

Measure

Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.

Time to Arrival at Referring Facility

66.0 minutes Interval 50.0 to 78.5

SECONDARY outcome

Timeframe: up to 240 minutes

This is the time interval (minutes) from when the BCH transport team arrives at the referring facility to when the transport team leaves the referring facility. This will be abstracted from transport records.

Outcome measures

Measure

Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.

Scene Time

51.5 minutes Interval 42.0 to 56.0

SECONDARY outcome

Timeframe: up to 240 minutes

This is the time interval (minutes) from when the BCH transport team leaves the referring facility to the time of arrival at BCH/BMC (the destination facility). This will be abstracted from transport records.

Outcome measures

Measure

Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.

Time to Arrival at Destination Facility

58.5 minutes Interval 49.0 to 70.5

SECONDARY outcome

Timeframe: up to 240 minutes

This time interval encompasses the time from when the transport team is dispatched to the referring facility to when they arrive at the destination (receiving facility). This will be abstracted from transport records.

Outcome measures

Measure

Teleconsultation Group n=20 encounters Eligible children managed by urban paramedic teams responding to 911 calls in the prehospital setting to support a future trial of clinical efficacy. Teleconsultation: Each subject will be remotely assessed by a Medical Control Physician (MCP) using Zoom Pro (HIPAA-compliant video-conferencing software) on tablet devices as a low-cost mobile telemedicine platform and the Respiratory Observation Checklist, validated for telemedicine use in emergency settings. All prehospital clinical decision making will be made at the discretion of evaluating paramedics as per standard state-approved protocols and procedures, independent of checklist results.

Total Transport Time

173.5 minutes Interval 159.0 to 202.5

Adverse Events

Teleconsultation Group

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Tehnaz Boyle, MD PhD

Boston Medical Center

Phone: 617-414-6382

Email: tehnaz.boyle@bmc.gov

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place