A telemedicine triage model for infusion center–based management of adult sickle cell pain episodes

Approximately 100 000 adults in the United States are affected by sickle cell disease (SCD). 1 Individuals with SCD seek acute care services for vaso-occlusive pain episodes (VOEs).Emergency department (ED) treatment of VOEs can be expensive, inefficient, and frustrating. 2Infusion center (IC)based management of acute SCD pain has proven to be more timely and is associated with higher provider and patent satisfaction than ED care. 2-4IC-based care has resulted in shortened time to first dose of parenteral analgesia, a key metric for high-quality SCD care per national guidelines, 5,6 along with decreased ED use and decreased system-wide healthcare costs. [7][8]][9][10] Standalone IC programs have emerged as a solution but require resources and personnel, which were unavailable at our institution.We sought to offer acute pain management services for VOEs in the outpatient setting and hypothesized that a telemedicine-guided same-day IC model would lead to lower ED use on a population level.