Virtual Sideline: Telehealth Integration to Reduce Diagnostic Misses in Rural mTBI

Mild traumatic brain injury (mTBI) is a frequently misdiagnosed neurological condition, particularly in rural and emergency settings where delayed EMS response and inconsistent diagnostic practices hinder early recognition. Rural patients disproportionately experience delayed neuroimaging, increasing the risk of missed diagnoses and adverse outcomes. This paper introduces a telehealth-integrated EMS model—“Virtual Sideline”—designed to address structural barriers to timely mTBI identification. By embedding remote clinical consultation into prehospital workflows, this approach captures transient symptoms such as loss of consciousness (LOC), alteration of consciousness (AC), and post-traumatic amnesia (PTA); reduces sole reliance on the Glasgow Coma Scale (GCS); and standardizes early evaluation across diverse EMS settings. The model is designed to sharpen diagnostic precision, promote equitable access to neurological assessment in rural contexts, and reduce the long-term consequences of undetected mTBI.