Acute Illness Care Patterns Change With Use of Telemedicine

McConnochie, Kenneth M.; Wood, Nancy; Herendeen, Neil E.; Ng, Phillip; Noyes, Katia; Wang, Hongyue; Roghmann, Klaus J.

doi:10.1542/peds.2008-2698

Cited by 76 publications

(71 citation statements)

References 17 publications

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“…Telemedicine has also successfully reduced the costs of healthcare and time related to physician travel in addition to reducing the time and out of pocket expenses for patients and families who may need to travel from remote or hard-to-reach locations for their care (49)(50)(51). In many cases, the use of telemedicine in the ambulatory setting has reduced the need for office visits and hospitalizations, mitigated the use of emergency department for nonemergency problems, increased parent satisfaction, and enhanced effective population health management (52). Evolving reimbursement models that emphasize value-based instead of volume-based care have the potential to further contribute to the adoption of telemedicine in the ambulatory setting.…”

Section: More Efficient Use Of Tertiary Care Resourcesmentioning

confidence: 99%

Addressing health disparities in rural communities using telehealth

2015

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The regionalization of pediatric services has resulted in differential access to care, sometimes creating barriers to those living in underserved, rural communities. These disparities in access contribute to inferior healthcare outcomes among infants and children. We review the medical literature on telemedicine and its use to improve access and the quality of care provided to pediatric patients with otherwise limited access to pediatric subspecialty care. We review the use of telemedicine for the provision of pediatric subspecialty consultations in the settings of ambulatory care, acute and inpatient care, and perinatal and newborn care. Studies demonstrate the feasibility and efficiencies gained with models of care that use telemedicine. By providing pediatric subspecialty care in more convenient settings such as local primary care offices and community hospitals, pediatric patients are more likely to receive care that adheres to evidence-based guidelines. In many cases, telemedicine can significantly improve provider, patient, and family satisfaction, increase measures of quality of care and patient safety, and reduce overall costs of care. Models of care that use telemedicine have the potential to address pediatric specialists' geographic misdistribution and address disparities in the quality of care delivered to children in underserved communities.

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Section: More Efficient Use Of Tertiary Care Resourcesmentioning

confidence: 99%

Addressing health disparities in rural communities using telehealth

2015

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“…Because only one SLC-based primary Full code 98 (21,(17)(18)(19)(20)(21)(22)(23)(24) 153 (20,(17)(18)(19)(20)(21)(22) *Care status categories not mutually exclusive.…”

Section: Limitationsmentioning

confidence: 99%

“…Studies of telemedicine for acute illnesses in children in schools and daycare facilities have found it to be highly feasible, acceptable, effective, and cost-effective. [15][16][17][18] Preliminary studies involving nursing home residents and other adult populations have also demonstrated the feasibility and acceptability of telemedicine, including its use for acute illness, and these studies have revealed enhancements in clinical care. [19][20][21][22][23][24][25][26][27][28][29] Thus, telemedicine may have significant value in the SLC setting; however, to our knowledge, no studies have evaluated this potential.…”

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confidence: 99%

Potential of Telemedicine to Provide Acute Medical Care for Adults in Senior Living Communities

Shah

McDermott

Gillespie

et al. 2013

Academic Emergency Medicine

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Objectives: Older adults dwelling in senior living communities (SLCs) often experience barriers to medical care when they experience acute illness. The potential of telemedicine as a substitute for standard routes of evaluating and caring for individuals with acute illness (e.g., in-person or telephonebased interactions with primary care providers and emergency department [ED] visits) was explored in this study. Methods:In this cross-sectional, observational study, the authors conducted a 6-month retrospective review of the medical records of adults enrolled in a university-affiliated geriatrics practice that offers onsite primary medical care in SLCs. For each episode of acute care, patient demographics, medical history, and chief complaint were collected and presented to an expert panel of physicians, who determined whether telemedicine could have been used to provide acute evaluation and care. The care actually provided, including outcomes, was also noted. Descriptive statistics were used to characterize the population and potential for telemedicine care.Results: The medical records of 646 patients were reviewed, accounting for 1,535 unique episodes of acute care. The expert panel identified 576 visits (38%) as potentially appropriate for telemedicinebased acute care, with 38, 47, and 27% of phone, in-home, and ED visits being eligible, respectively. Chief complaints most likely to be deemed potentially appropriate were falls and dermatologic, respiratory, and gastrointestinal illnesses, representing 58% of visits identified for telemedicine-based acute care.Conclusions: Telemedicine has a potentially significant role in the provision of acute care for older adults residing in SLCs. Studies are needed to evaluate the feasibility, acceptability, effectiveness, and efficiency of acute care telemedicine for this population.ACADEMIC EMERGENCY MEDICINE 2013; 20:162-168

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“…Previous studies have evaluated the feasibility of telemedicine in assessing and treating ill children. [9][10][11] Few studies have formally evaluated how reliable telemedicine is; that is, whether data presented with telemedicine are similar to observations made at the bedside. 12 In addition, the evaluation of a seriously ill child poses a challenge for telemedicine in that telemedicine is primarily visual in its application and has limited ability to perform nonvisual components of the physical examination (eg, palpation, percussion).…”

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confidence: 99%

Reliability of Telemedicine in the Assessment of Seriously Ill Children

Siew¹,

Hsiao²,

McCarthy³

et al. 2016

Pediatrics

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BACKGROUND AND OBJECTIVE: Data are limited that establish the clinical reliability of telemedicine in evaluating children who are seriously ill. Evaluation of a seriously ill child poses a challenge in that telemedicine is primarily visual, without the ability to perform a "hands-on" physical examination. Previous studies evaluating observation in assessing febrile children and children in respiratory distress have validated observation as both predictive and reliable in detecting underlying illness. The purpose of this study was to determine the interobserver reliability of telemedicine observations, compared with bedside observations, in assessing febrile children and children in respiratory distress.

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Acute Illness Care Patterns Change With Use of Telemedicine

Abstract: The Health-e-Access telemedicine model holds potential to reduce health care costs, mostly through replacement of ED visits for nonemergency problems.

Cited by 76 publications

References 17 publications

Addressing health disparities in rural communities using telehealth

Addressing health disparities in rural communities using telehealth

Potential of Telemedicine to Provide Acute Medical Care for Adults in Senior Living Communities

Reliability of Telemedicine in the Assessment of Seriously Ill Children

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