Feasibility of portable telemedicine devices for ambulance-based prehospital triage: a comparative simulation study.
Scandinavian journal of trauma, resuscitation and emergency medicine · 2026-04-23 · Method & validation
Abstract
BACKGROUND: Video-based telemedicine can improve prehospital triage. However, it is unclear which portable device enabling a real-time specialist consultation via two-way video and audio connection in dynamic emergency medical service environments should be used. This feasibility study identified the most suitable portable telemedicine device for prehospital triage. METHODS: Four simulated stroke-like scenarios were conducted with ambulance professionals and remote vascular neurologists. Three portable telemedicine devices were tested: two head-mounted assisted-reality devices (RealWear Navigator ™ 520, Vuzix M400) and a smartphone using Siilo Messenger application. Feasibility was evaluated through structured surveys from both user groups and a patient actor. Quantitative data were analysed using Multi-Criteria Decision Analysis with stakeholder-derived criterion weights to generate overall value scores and device ranking. RESULTS: Out of 47 analysed surveys, the Vuzix head-mounted device achieved the highest overall value score (0.80), followed by Siilo Messenger smartphone application (0.77) and RealWear head-mounted device (0.73). Ambulance professionals prioritised usability, favouring the smartphone application, whereas neurologists emphasised video quality, favouring Vuzix head-mounted device. Qualitative feedback highlighted trade-offs: head-mounted devices offered hands-free use but required peripherals and hindered patient interaction, while smartphones were intuitive but limited by video quality and image stability. CONCLUSIONS: Device suitability for prehospital telemedicine depends on balancing technical performance with usability. The smartphone-based application provides practical solution for early implementation, while head-mounted devices may be preferable when hands-free operation and video quality are critical. Future research should assess their clinical and operational impact to enable safe and scalable implementation.