A broad evidence base, with important variation
A 2026 systematic review in Annals of Internal Medicine included 33 studies and 609,188 patients. Telemedicine was frequently associated with fewer interhospital transfers across several populations and settings. The authors used narrative synthesis because the studies differed substantially.
Most studies were observational and subject to confounding. Technology, clinical populations, comparators, and program design varied. The review supports evaluating consultation as a care model; it does not establish a single transfer-reduction percentage or guarantee equivalent results in a new rural ED program.
Randomized evidence from pediatric emergency care
Marcin and colleagues enrolled 696 acutely ill children at 15 community and rural EDs in a cluster-randomized crossover trial. Assignment to video consultation with pediatric critical care physicians was associated with a 7% lower adjusted relative risk of transfer to the referral children’s hospital than telephone consultation (RR 0.93; 95% CI 0.88–0.99). This is a relative reduction, not a seven-percentage-point absolute reduction.
This was a pediatric specialist consultation model. It does not directly establish the effect of general adult emergency physician consultation or of CrossCheck’s planned workflow. Its relevance is that the information available during a consultation and the model used can matter.
Rural networks and the cost of averted transfers
Ward and colleagues evaluated averted transfers and estimated transport costs across six rural emergency telemedicine networks. The study is relevant to planning because it examines actual network use and the economic implications of selected transfer decisions.
This observational evaluation does not establish that every local discharge resulted from telemedicine or that transport savings equal hospital savings. A new program should define how transfer decisions are reviewed and measure its own costs and safety outcomes.
How we use this evidence
These studies inform consultation design, choice of measures, and questions to test with hospital partners. They do not justify a promise to eliminate transfers. CrossCheck’s goal is to support safe local care when appropriate and timely escalation when a patient needs capabilities elsewhere.
This page is an organizational research summary, not a clinical practice guideline. Publication details and source links were checked on the date shown. We will add relevant evidence as it becomes available and distinguish independent research from vendor case studies.
Your next steps
- Read the original study before using a statistic in a proposal.
- Check whether the study population and consultation model match yours.
- State design limitations next to any benefit claim.
- Collect local clinical, operational, and economic outcomes.
CrossCheck is developing pilot partnerships with rural Oklahoma hospitals. These guides describe the proposed model, not a guarantee of current coverage. Availability, response expectations, credentialing, and responsibilities must be confirmed before service begins.