Skip to content Skip to navigation

Telemedicine Consultations Improve Pediatric Care in Rural ERs, Study Finds

August 12, 2013
by Rajiv Leventhal
| Reprints

The quality of care for pediatric patients in rural emergency rooms—where pediatricians and pediatric specialists are scarce—improved significantly when delivered via telemedicine consultations, according to a study by researchers at the 129-bed UC Davis Children’s Hospital.

The use of technology to link far-distant practitioners has been steadily increasing in American medicine, particularly as a tool to provide rural and underserved communities with access to specialty physicians. More recently, telemedicine has been used for consultations to emergency rooms, and is particularly recommended for use in the area of stroke care.

The study, which was published in the journal Critical Care Medicine, also found that rural emergency room physicians are more likely to adjust their pediatric patients’ diagnoses and course of treatment after a live, interactive videoconference with a specialist. Parents’ satisfaction and perception of the quality of their child’s care also are significantly improved when consultations are provided using telemedicine, rather than telephone, and aid emergency room treatment, the study found.

The study involved 320 seriously ill or injured patients 17 years old and younger. The patients were treated at five rural Northern California emergency departments between 2003 and 2007. The rural hospitals’ emergency departments were equipped with videoconferencing units to facilitate telemedicine consultations. The interactive audiovisual communications involved the rural emergency room physicians, pediatric critical-care medicine specialists at UC Davis Children’s Hospital, nurses, the patients and their parents.

Fifty-eight consultations were conducted using telemedicine consultations and 63 consultations were conducted using telephone; 199 participants did not receive specialist consultations. The researchers compared the quality of care, accuracy of diagnosis and course of treatment, and overall satisfaction for all of the patients included in the study. Quality of care was evaluated using medical record review by two independent, unbiased emergency medicine physician experts.

Overall, cases involving a telemedicine consultation received significantly higher quality-of-care scores than did those involving a telephone consultation or no consultation. In addition, rural emergency room physicians were far more likely to change their diagnosis and treatment plans when consultations were provided using telemedicine, rather than telephone. Parents’ satisfaction and perception of the quality of care also were significantly greater when telemedicine was used, compared to telephone guidance.

Madan Dharmar, Ph.D., assistant research professor in the pediatric telemedicine program and lead author of the study, said the results underscore the important role telemedicine can play in rural emergency departments, which often lack specialists and tools needed to treat pediatric patients, such as specially sized pediatric ventilators, to treat critically ill children. While 21 percent of children in the U.S.  live in rural areas, only 3 percent of pediatric critical-care medicine specialists practice in such areas, Dharmar said.

“This research is important," Dharmar said in a statement, "because it is one of the first published studies that has evaluated the value of telemedicine against the current standards of care from three different viewpoints—the emergency room physician; the parents of the patients; and the actual quality of care and patient outcome.”

Added James Marcin, M.D., director of the UC Davis Children’s Hospital Pediatric Telemedicine Program and the study’s senior author, “The bottom line is that this readily available technology can and should be used to improve the quality of care delivered to critically ill children when there are no pediatric specialists available in their own communities. People say a picture is worth a thousand words. With medicine, video conferencing brings us right to the bedside, allowing us to see what’s happening and collaborate with on-site doctors to provide the best possible care to our patients.”

Health IT Summit Series - Focus: TELEHEALTH

Get the latest information on Telehealth, and attend other valuable sessions at this two-day, intimate event bringing together C-level, physician, practice management and IT decision makers for strategy discussions, knowledge exchange, and one-on-one meetings.

Boston, June 23-24   |   Denver, July 12-13
Topics

News

House Ways and Means Committee Advances Bill to Provide Regulatory Relief for Docs

May 26, 2016
The U.S. House Committee on Ways and Means has passed a bill that among other provisions, would provide relief to hospital outpatient departments as well as consider patients’ socioeconomic status before penalizing hospitals in the Hospital Readmissions Reduction Program.

Health IT Leaders Address Cybersecurity Responsibilities at HHS during Congressional Hearing

May 25, 2016
During a House Energy and Commerce Subcommittee on Health hearing, healthcare IT leaders and security experts testified in support of proposed legislation to elevate and empower the CISO at the U.S. Department of Health and Human Services (HHS).

Study: Automated, Real-Time Surveillance Significantly Reduced Sepsis Mortality

May 25, 2016
Automated surveillance and real-time analysis led to a significant reduction in sepsis mortality at Alabama’s Huntsville Hospital, according to research recently published in the Journal of the American Medical Informatics Association (JAMIA).

Report: Bill to Fight Zika Could Strip HHS of MACRA Funds

May 25, 2016
With a House bill providing money to fight the Zika virus pending, the Department of Health and Human Services (HHS) may be stripped of funds that it was planning to use for Medicare Access and CHIP Reauthorization Act (MACRA) information technology provisions, according to a Morning Consult report.

Healthcare Organizations Push to Look at New Data Sources to Assess Telemedicine in Medicare

May 24, 2016
Several healthcare organizations have sent a letter to the Congressional Budget Office (CBO) and the Medicare Payment Advisory Commission (MedPAC) regarding the use of alternative data sources for cost estimates and analyses of telemedicine utilization in the Medicare program.

Study: Sharing Visit Notes with Patients Improves Patient Satisfaction, Trust and Safety

May 24, 2016
Improving transparency between physicians and their patients by allowing patients to view their visit notes in their health records can improve patient satisfaction, trust and safety, according to a recently published study.

CareFirst BlueCross BlueShield Awards $3M to Regional Telemedicine Programs

May 24, 2016
Baltimore-based CareFirst BlueCross BlueShield plans to award nearly $3 million to ten healthcare organizations to help develop or expand existing regional telemedicine initiatives.

Intermountain Launches New Telehealth Service

May 24, 2016
Intermountain Healthcare has launched a new telehealth service that connects patients in Idaho and Utah with the health system’s providers 24 hours a day, 7 days a week, through video and audio conferencing on the web.

Kansas Heart Hospital Hit With Ransomware; Hackers Do Not Unlock Files After Receiving Ransom Payment

May 23, 2016
Wichita, Kan.-based Kansas Heart Hospital was hit with a ransomware attack last Wednesday, but after the hospital paid an undisclosed ransom, the hackers demanded more, according to local news reports.

Intermountain Healthcare Names New CEO

May 23, 2016
Salt Lake City-based Intermountain Healthcare has appointed A. Marc Harrison, M.D., as its new president and CEO to take the helm when current CEO Charles Sorenson, M.D., retires in October.

Study: Hospitals Making Significant Investments in Smartphone-Based Communications

May 20, 2016
Sixty-three percent of hospitals and health systems have deployed or plan to deploy a mobile communications platform supporting more than 500 smartphones in the next year, according to a new survey from Spyglass Consulting Group.

UConn Health Appoints Dirk Stanley, M.D., as First CMIO to Oversee EMR Implementation Project

May 20, 2016
The University of Connecticut Health Center (UConn Health), based in Farmington, Conn., has announced the appointment of Dirk Stanley, M.D., as its first Chief Medical Information Officer.

Potential Data Breach at Children’s National Health System Due to Vendor Misconfiguration

May 20, 2016
Children’s National Health System, based in Washington, D.C., has issued a notice about a potential data breach after a third-party vendor inadvertently misconfigured a file site that enabled patient information to be accessed online.

CHIME, AEHIS, Offer Suggestions to Lawmakers for Improved Cybersecurity

May 20, 2016
The College of Healthcare Information Management Executives (CHIME) and the Association for Executives in Healthcare Information Security (AEHIS) have written a statement to lawmakers offering suggestions for how to bolster healthcare cybersecurity.

MUSC Health Invests $36M in Patient Monitoring Technology Partnership

May 20, 2016
Charleston-based Medical University of South Carolina Health (MUSC Health) announced an 8-year, $36 million strategic partnership with Philips to implement integrated patient monitoring technologies.

Pages