Emergency CareNCT07546071
Telemedicine-Based Emergency Physician Assessment Prior to ED Entry: A Randomized Controlled Trial
A study testing Telemedicine-Based Remote Physician Assessment in people with Emergency Care and Telemedicine, run by Sheba Medical Center at 1 site in Israel.
Trial summary
Background: Emergency department (ED) overcrowding is a growing challenge worldwide and is associated with prolonged length of stay (LOS), reduced patient satisfaction, and increased burden on healthcare systems. New approaches are needed to improve how patients are evaluated and treated. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Emergency Care, Telemedicine, Emergency Department Crowding
- What is being tested?
- Telemedicine-Based Remote Physician Assessment
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 200 participants
- Where
- 1 siteIsrael
- Study dates
- 18 Nov 2025to 31 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 18 years and older
- Presentation to the emergency department during study recruitment hours
- Ability to provide written informed consent
Who cannot join
- Pregnancy
- Arrival by ambulance
- Severe pain, defined as a Visual Analogue Scale (VAS) score of 8 or higher
- Emergency Severity Index (ESI) level 1 or 2
- Language barriers or technological difficulties without an accompanying person able to assist
- Isolated orthopedic complaints with suspected fracture or dislocation
- Repeat emergency department visit for the same complaint within the previous 72 hours
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Randomized Controlled Trial Comparing the Safety and Efficiency of a Virtual-Hybrid Emergency Department Model Versus Standard Emergency Department Management in Non-Urgent Patients
Background:
Emergency department (ED) overcrowding is a growing challenge worldwide and is associated with prolonged length of stay (LOS), reduced patient satisfaction, and increased burden on healthcare systems. New approaches are needed to improve how patients are evaluated and treated.
Read more
Telemedicine has been increasingly integrated into ED care and has shown feasibility and benefits in various settings. Existing models have demonstrated improvements in patient flow, reduced length of stay, and high patient satisfaction. However, despite the growing use of telemedicine in emergency medicine, there is a lack of randomized controlled trials evaluating its effectiveness and safety, particularly in models involving early remote physician assessment prior to ED evaluation.
Purpose:
This study aims to evaluate whether a video consultation with a senior emergency physician before entering the ED can improve the efficiency and quality of care. The study also examines whether physicians can accurately identify which patients need ED evaluation based on a remote assessment, while maintaining patient safety.
Methods:
A total of 200 adults who arrived at the ED were assigned to one of two groups. In the study group, participants had a video consultation with a physician before continuing with standard ED care.
In the control group, participants received standard ED care only.
During the video consultation, the physician performed an initial clinical assessment and could order tests or specialist consultations. The physician was also asked what their recommendation would have been if the participant had been assessed from home. Three possible decisions were recorded:
- Immediate ED presentation
- Scheduled ED presentation at a later time
- Continued care in the community without ED presentation
Outcomes:
The primary outcomes focus on the effectiveness of the intervention. These include:
- ED length of stay
- Patient satisfaction
- The ability of physicians to accurately identify participants who require ED evaluation The secondary outcome is safety, assessed by return visits to the ED within one week for the same complaint.
- Conditions
- Emergency Care, Telemedicine, Emergency Department Crowding
- Being tested
- Telemedicine-Based Remote Physician Assessment
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Telemedicine-Based Remote Physician AssessmentBehavioural
Participants undergo an initial video consultation with a senior emergency physician prior to continuing with standard emergency department care. The consultation includes a clinical assessment and may involve ordering diagnostic tests or specialist consultations.
| Study group | Role | What they receive |
|---|---|---|
| Study Group / Telemedicine Group | Experimental | Participants undergo an initial video consultation with a senior emergency physician prior to continuing with standard emergency department care. Receives: Behavioral: Telemedicine-Based Remote Physician Assessment |
| Control Group | No intervention | Participants receive standard emergency department care without a prior video consultation. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Emergency Department Length of Stay
Emergency department length of stay, defined as the time from emergency department registration to discharge or hospital admission during the index visit, measured in hours. Data will be extracted from the hospital electronic medical record one week after the visit.
Measured: From emergency department registration to the final decision regarding discharge or hospital admission during the index visit, up to 24 hours.
Secondary outcomes (3)
Return Visits to the Emergency Department
Return visits to the emergency department within one week for the same complaint.
Measured: Within one week after the ED visit
Accuracy of Physician Assessment for ED Referral
The ability of physicians to identify participants requiring emergency department evaluation based on the initial video consultation, assessed by comparing physician recommendations to actual clinical outcomes.
Measured: From the baseline physician assessment at the initial video consultation, to the final clinical outcome at the end of the index visit (discharge or hospital admission), up to 24 hours.
Patient Satisfaction
Patient satisfaction will be assessed using the Short Assessment of Patient Satisfaction (SAPS) questionnaire, administered via SMS one week after the emergency department visit. The SAPS is a validated 7-item questionnaire that assesses multiple aspects of patient satisfaction. Total scores range from 0 to 28, with higher scores indicating greater patient satisfaction. Scores of 0 to 10 indicate Very dissatisfaction, 11 to 18 indicate dissatisfaction, 19 to 26 indicate satisfaction, and 27 to 28 indicate very high satisfaction.
Measured: One week after the ED visit
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Apr 2026
- Study start18 Nov 2025
- Primary completion31 Jan 2026
- Study completion31 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Emergency CareStudies of the same condition, open and under way.
- More trials run by Sheba Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 200 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sheba Medical Center
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Avi Epstein, Sheba Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07546071
- Sponsor's protocol ID
- SMC-2688-25
- Status last verified
- Apr 2026
- First submitted
- 5 Apr 2026
- Last updated
- 7 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Controlled Trial Comparing the Safety and Efficiency of a Virtual-Hybrid Emergency Department Model Versus Standard Emergency Department Management in Non-Urgent Patients
- ClinicalTrials.gov ID
- NCT07546071
- Acronym / sponsor ID
- SMC-2688-25
- Conditions
- Emergency Care, Telemedicine, Emergency Department Crowding
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 200 participants (actual)
- Lead sponsor
- Sheba Medical CenterOther government
- Study start
- 18 Nov 2025 (actual)
- Primary completion
- 31 Jan 2026 (actual)
- Study completion
- 31 Jan 2026 (actual)
- First posted
- 22 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background:
Emergency department (ED) overcrowding is a growing challenge worldwide and is associated with prolonged length of stay (LOS), reduced patient satisfaction, and increased burden on healthcare systems. New approaches are needed to improve how patients are evaluated and treated.
Telemedicine has been increasingly integrated into ED care and has shown feasibility and benefits in various settings. Existing models have demonstrated improvements in patient flow, reduced length of stay, and high patient satisfaction. However, despite the growing use of telemedicine in emergency medicine, there is a lack of randomized controlled trials evaluating its effectiveness and safety, particularly in models involving early remote physician assessment prior to ED evaluation.
Purpose:
This study aims to evaluate whether a video consultation with a senior emergency physician before entering the ED can improve the efficiency and quality of care. The study also examines whether physicians can accurately identify which patients need ED evaluation based on a remote assessment, while maintaining patient safety.
Methods:
A total of 200 adults who arrived at the ED were assigned to one of two groups. In the study group, participants had a video consultation with a physician before continuing with standard ED care.
In the control group, participants received standard ED care only.
During the video consultation, the physician performed an initial clinical assessment and could order tests or specialist consultations. The physician was also asked what their recommendation would have been if the participant had been assessed from home. Three possible decisions were recorded:
- Immediate ED presentation
- Scheduled ED presentation at a later time
- Continued care in the community without ED presentation
Outcomes:
The primary outcomes focus on the effectiveness of the intervention. These include:
- ED length of stay
- Patient satisfaction
- The ability of physicians to accurately identify participants who require ED evaluation The secondary outcome is safety, assessed by return visits to the ED within one week for the same complaint.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Study Group / Telemedicine Group | Experimental | Behavioral: Telemedicine-Based Remote Physician AssessmentParticipants undergo an initial video consultation with a senior emergency physician prior to continuing with standard emergency department care. |
| Control Group | No intervention | –Participants receive standard emergency department care without a prior video consultation. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Adults aged 18 years and older
- Presentation to the emergency department during study recruitment hours
- Ability to provide written informed consent
Key exclusion criteria (7 listed)
- Pregnancy
- Arrival by ambulance
- Severe pain, defined as a Visual Analogue Scale (VAS) score of 8 or higher
- Emergency Severity Index (ESI) level 1 or 2
- Language barriers or technological difficulties without an accompanying person able to assist
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Telemedicine-Based Remote Physician AssessmentParticipants undergo an initial video consultation with a senior emergency physician prior to continuing with standard emergency department care. The consultation includes a clinical assessment and may involve ordering diagnostic tests or specialist consultations. | Behavioural | Study Group / Telemedicine Group |
Primary outcome
Emergency Department Length of Stay
Time frame: From emergency department registration to the final decision regarding discharge or hospital admission during the index visit, up to 24 hours.
Emergency department length of stay, defined as the time from emergency department registration to discharge or hospital admission during the index visit, measured in hours. Data will be extracted from the hospital electronic medical record one week after the visit.
3 secondary outcomes
Return Visits to the Emergency Department
Time frame: Within one week after the ED visit
Accuracy of Physician Assessment for ED Referral
Time frame: From the baseline physician assessment at the initial video consultation, to the final clinical outcome at the end of the index visit (discharge or hospital admission), up to 24 hours.
Patient Satisfaction
Time frame: One week after the ED visit
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Telemedicine-Based Remote Physician Assessment in people with Emergency Care and Telemedicine, run by Sheba Medical Center at 1 site in Israel.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Emergency Department Length of Stay (time frame: From emergency department registration to the final decision regarding discharge or hospital admission during the index visit, up to 24 hours.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 May 2026.