Annals of emergency medicine
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The Centers for Disease Control and Prevention (CDC) recently released revised recommendations for HIV testing in health care settings, calling for the performance of nontargeted opt-out HIV screening, the integration of informed consent for HIV testing into the general consent for medical care, and the uncoupling of prevention counseling and testing. It is unclear, however, whether patients will understand opt-out screening or be satisfied with integration of the consent for HIV testing into the general medical consent or the uncoupling of counseling from testing. The objective of this study is to evaluate patients' acceptance of the CDC's revised recommendations in an urban emergency department (ED). ⋯ A large proportion of ED patients appear willing to be screened for HIV infection in accordance with the CDC's revised recommendations for HIV testing in health care settings. Similar proportions were willing to be tested when opt-out or opt-in screening strategies were used; however, a significantly greater proportion required explanation of opt-out screening.
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Providing rural emergency medical care is often difficult because of limited resources and a scarcity of medical providers, including physicians trained in emergency medicine. Telemedicine offers promise for improving the quality of care in rural areas, but previous models were not well designed to provide affordable care to unstable or potentially unstable patients. ⋯ Since its inception in October 2003, the TelEmergency program has evaluated and treated more than 40,000 patients in 11 rural EDs throughout Mississippi, with a high degree of satisfaction from patients and hospital administrators. This article details the development and implementation of this system and describes the patient population that has been evaluated.