SAFE-T System Telehealth Sexual Assault Nurse Examiner (TeleSANE) Consultation: Real-Time Changes to Medical Forensic Examinations for Adolescent and Adult Survivors in Rural and Underserved Communities.

BACKGROUND

Telehealth technology can expand access to expert sexual assault nurse examiner (SANE) care in rural and underserved areas. Research previously demonstrated that telehealth-supported sexual assault nurse examiner (teleSANE) intervention led to changes in examination methods and evidence collection practices among a pediatric population; however, little is known about the impact of the intervention on changes among adolescent and adult victims of sexual assault (SA). The purpose of this study is to examine how SAFE-T SystemTM teleSANE consultations influence medical forensic examination (MFE) recommendations and changes for adolescent and adult survivors of SA in rural and suburban communities.

METHODS

From June 2021 to September 2024, SAFE-T System teleSANEs provided 24/7 live telehealth consultations to local SANE-trained nurses at 11 hospitals in rural or suburban communities. A researcher-developed quality assurance tool was completed to assess the impact of the teleSANE consultation.

RESULTS

Analysis of 178 teleSANE consultations conducted by 18 teleSANEs partnered with 64 local SANEs across 11 hospitals. TeleSANE consultations resulted in changes across 7 domains and 12 subcategories: The 8 domains include: Patient-centered Communication (67.4%); Initial History/Data Gathering (42.1%); Forensic Evidence Collection (78.7%); Use of Multimethod Techniques (65.7%); Use of Adjunct Techniques (60.1%); Photo Documentation (51.1%) and Quality (59.6%); Post-assault Clinical Recommendations (43.8%); and Strangulation Evaluation (17.5%).

CONCLUSIONS

Telehealth technology partnering expert teleSANEs with local SANEs in forensic specialty limited-access areas resulted in substantive changes to MFEs. These changes may reflect improved quality of care and enhanced forensic evidence collection.