Can a virtual consult avert a patient transfer?

Clinical takeaway: When specialty input is available remotely, telemedicine may support safer, more selective interhospital transfer decisions—especially in settings where transfer risk, resource use, or patient/family burden is high.

Interhospital transfers can be lifesaving when specialized care is needed, but potentially avoidable transfers may add delays, costs, family disruption, and strain on receiving hospitals.

Telemedicine was often associated with fewer hospital-to-hospital transfers, without an apparent increase in mortality, according to a systematic review published July 7 in Annals of Internal Medicine.

Researchers from McGill University and the University of Toronto reviewed 33 studies including 609,188 adult and pediatric patients to assess whether incorporating telemedicine into transfer decision-making was associated with reduced interhospital transfers. Because the studies differed substantially in design, patient populations, and clinical contexts, the authors summarized the findings qualitatively rather than pooling the data.

Across medical and surgical settings, most studies found that telemedicine was associated with lower transfer rates. The pattern was seen in both adult and pediatric populations, suggesting that remote specialty consultation may help clinicians identify patients who can be managed safely at the presenting hospital.

Importantly, the review did not find evidence that telemedicine-assisted decision-making was associated with worse mortality outcomes. However, the authors rated the certainty of evidence as very low, citing substantial heterogeneity across the included studies.

The authors concluded that telemedicine “could reduce potentially avoidable interhospital transfers” and may help guide transfer decisions, while emphasizing that stronger research is needed to determine causality, cost-effectiveness, and the operational burden of adding telemedicine to transfer workflows.

Source: D’Arienzo D, et al. (2026 July 7) Ann Intern Med. The Role of Telemedicine on Interhospital Transfer Outcomes: A Systematic Review