The poison control system, an established network covering the United States, is in place to reduce poison-related morbidity, mortality, and hospital admissions. Poison Control Centers (PCC) receive calls from the public and healthcare facilities for toxicological consultation after a suspected poisoning or overdose has occurred. The PCCs are staffed by pharmacists, physicians, medical toxicology specialists and nurses with specialized clinical toxicology training and operate 24 hours a day, every day of the year. For every dollar spent on poison control, at least $7 is saved in public health care costs due to instant intervention and effective use of resources, often by preventing unnecessary and costly visits to the emergency room. PCCs are state and federally funded but funds have been cut significantly making it more important that the PCCs operate as efficiently and productively as possible.
PCCs currently perform most of their duties through the use of telemedicine – which in the majority of cases means a telephone. Typically, PCCs provide the following services:
- Poisoning triage and treatment to the public
- Poisoning triage, consultations and medical recommendations to ED physicians and emergency medical transport personnel
- Toxicological consultation after and medical recommendations to rural healthcare facilities and medically underserved regions
- Toxicological services to non-healthcare organizations such as correctional institutions, cruise ships, etc.
- Input and advice regarding hazardous materials toxicity and management to the state’s emergency management agencies
- Analyzes calls in real-time for trends and events that might be of public health significance (e.g. food poisoning, terrorism, product recalls)
- Public health services during disasters (with adaptation to workflows)
- Perform patient “follow‐ups” and/or home management of poisoning services
- Consultation services to patients (e.g. counseling and information for drug and other exposures during pregnancy and lactation)
- Training site for pharmacy students, nurses, EMS/paramedic students, and physicians and residents in emergency medicine, pediatrics, family practice and other specialties
- Increase public awareness, education and prevention services to the public of common toxic substances, specifically as they relate to young children
- Poisoning triage, treatment, education, and prevention services for animals
In the near future, PCCs will provide many of these services via technology. Easy to implement and cost-effective use of technology will include connecting with the public through text messaging, Twitter and Facebook or publishing Podcasts on YouTube to share health content with the general public. Clinical toxicologists’ collaboration with physicians and emergency medical personnel will take place via desktop sharing and web conferencing. The use of emerging telemedicine technologies that leverage audio and videoconferencing within poison centers will enhance the ability of the clinical toxicologists to deliver services to their patients. For example, PCCs may use a telemedicine kiosk or cart that supports visual clinical toxicologists/patient encounters through the use of telepresence, remote-controlled point-of-care camera, FDA approved medical devices and an EMR. Many organizations currently utilizing telemedicine are considering a model that is internet based. This would allow PCCs to work with doctors and patients from any location utilizing any computer or similar device.
All of these technologies will help PCCs achieve the primary goal of improving access to care while lowering the overall cost of care.