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Chin Med J (Taipei) 1998;61:S143.
The Future of Emergency Medicine, Taiwan
Emergency Medicine defines its role as "unlimited access, 24 hours a day, for any person in an acute health crisis." Further it recognizes the need to provide the same level of care 24 hours a day, 7 days a week (Attending or possibly Senior Fellow coverage); and a safe, appropriate, and timely disposition for each ED patient.
5 Areas that must be addressed:
1. Manpower Requirements
2. Training Needs
3. Prehospital Care
4. Interhospital Transfers
5. Adequate Support Systems
North America
In the United States future directions are being driven by attempts to decrease money spent on medical care in the forms of managed care, HMOs, and cut in federal spending. In response Emergency Medicine is variously promoting: observation areas in the ED to decrease hospital admissions, specialty EDs such as chest pain centers as being more cost effective than CCU care, an expanded Critical Care role as part of a hospitalist's function, an expanded public health role such as providing unmunizations to non-insured children visiting the ED, to greater involvement in accident and disease prevention.
In Canada immediate future concerns include evaluating the merits of two divergent streams of Emergency Medical training ( 5 years of Emergency Medicine vs 2 years of Family Medicine plus I year of Emergency Medicine ). The former is designed as the academic option but several reports have suggested no difference in practise profile 10 years after training. Residency positions are already controlled under the government funded system.
The major changes that everyone is working toward is the ability to get quicker access to information, from smart cards with each patient's updated medical data to instant intranet intrafacility patient information, to convenient digital and patient imaging for remote consultations, and ongoing accurate complete data collection sets and continuous analysis to provide continuous quality improvement, identify unexpected problems, and conduct research.
[Chin Med J (Taipei) 1998;61:S143.]
Copyright: 1998, Chinese Medical Association (Taipei)