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

Survey: Majority of Hospitals Face Challenges, Lack of Readiness for eCQM Data Reporting

July 26, 2016
More than three-fourths of hospitals, or 78 percent, still have work ahead of them in order to successfully submit electronic clinical quality measures (eCQM) data as part of the Hospital Inpatient Quality Reporting (IQR) program by the Feb. 28, 2017 deadline.

HHS to Fund Cybersecurity Information Sharing Organization

July 26, 2016
The U.S. Department of Health and Human Services plans to fund a cybersecurity information sharing and analysis organization for the healthcare and public health sector.

Study: Medical Students Use EHRs to Track Former Patients

July 26, 2016
Medical students are continually using electronic health records (EHRs) in training, using the technology to track former patients after they have left one’s direct care, according to new research published in JAMA Internal Medicine.

NewYork-Presbyterian Launches Enterprise-Wide Digital Health Services Platform

July 26, 2016
NewYork-Presbyterian, a New York City-based integrated healthcare delivery system comprised of nine hospitals, is rolling out a new suite of digital health services, NYP OnDemand, with a particular focus on expanded telehealth services.

athenahealth Says it will Cover MIPS Payment Penalties for Customers

July 25, 2016
athenahealth has said that if customers using the company’s athenaOne services get hit with Merit-Based Incentive Payment System (MIPS) payment penalties, it will cover the financial consequences for those unsuccessful practices.

OIG Study Finds 60 Percent of Hospitals Experienced EHR Disruptions, Highlights Importance of Contingency Plans

July 25, 2016
Close to 60 percent of hospitals have experienced an unplanned disruption to their EHR systems and a quarter of those hospitals experienced delays in patient care as a result, according to a study released by the HHS Office of Inspector General (OIG).

University of Mississippi Medical Center Agrees to Pay $2.75M to Settle Potential HIPAA Violations

July 25, 2016
The University of Mississippi Medical Center (UMMC) has signed a resolution agreement with the U.S. Department of Health and Human Services Office for Civil Rights (OCR) following an investigation of a data breach of unsecured PHI that occurred in 2013.

HHS Grants $36M in Funding for Health IT Improvement

July 25, 2016
Health and Human Services (HHS) Secretary Sylvia M. Burwell has announced more than $36 million in funding for 50 Health Center Controlled Networks (HCCNs) that will aim to greatly increase health IT support across the country.

Study: Data-Driven Physiologic Alarm Parameters Can Help Reduce Alarm Fatigue

July 22, 2016
Alarm fatigue from clinical decision support systems is a significant hazard in hospitals. In a recent study, researchers found that tailoring bedside monitor alarm limits using data-driven physiologic parameters can mitigate alarm fatigue.

New CMS Initiative will Leverage Predictive Modeling to Prevent Heart Attacks and Strokes

July 22, 2016
A new program released by the Centers for Medicare & Medicaid Services (CMS) will aim to decrease cardiovascular disease risk by leveraging data analytics by assessing an individual patient’s risk for heart attack or stroke and applying prevention interventions.

Justice Department, State Attorneys General Sue to Block Anthem, Aetna Deals

July 21, 2016
The U.S. Department of Justice announced Thursday that the department, along with attorneys general from multiple states, filed lawsuits to block Anthem’s proposed acquisition of Cigna and Aetna’s pending acquisition of Humana.

Study: Large Health Systems Investing in Strategic Initiatives to Address Patients’ Social Needs

July 21, 2016
Several health systems have been investing core operating dollars to address the social needs of patients in order to improve overall health outcomes, and are integrating that work into core clinical systems, according to a new study from the Bridgespan Group.

Survey of Health IT Pros Reveals High and Frequent Stress Levels

July 21, 2016
A survey of approximately 500 health IT professionals by HealthITJobs.com has revealed that 55 percent of such professionals are frequently or constantly stressed, and 38 percent say their stress is high or extremely high.

Survey: 74 Percent of Physician Specialties Saw Increased Compensation in 2015

July 20, 2016
Average physician compensation increased 3.1 percent in 2015, with 74 percent of physician specialties experiencing increases, according to the latest AMGA Medical Group Compensation and Productivity Survey.

NCPA Senior Fellow Calls MACRA “A Poor Solution”

July 20, 2016
A report from the National Center for Policy Analysis (NCPA) has assessed that the "doc fix” contained in the Medicare Access and CHIP Reauthorization Act (MACRA) is fiscally irresponsible, and will only increase federal control over how doctors practice medicine.

Pages