Clinical telemedicine utilization in paediatric nephrology at a tertiary care centre

Shao, Fei; Andody, Jody; Reed, April; Filler, Guido

doi:10.5206/uwomj.v86i1.2132

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Remote patients may live more than 1,400 km away from the tertiary center provided at The University of Western Ontario, London Health Science Centre. Telemedicine offers a means to provide timely care to patients in remote areas [ 5 , 6 ]. Over a five year period 652,337 Ontario telemedicine network visits were recorded [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Qiu

McIntyre

Wile

et al. 2021

BMC Health Serv Res

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Background Telemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We compared both adolescent and caregiver (parent or guardian) attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness. Methods This qualitative research study analyzed transcribed structured telephone interviews with both 11–18 year-old pediatric nephrology patients and their caregivers and performed a quantitative analysis of patient demographics, disease factors and distance to tertiary center vs. telemedicine center. Results The study was conducted in a medium-sized tertiary pediatric nephrology centre with a large catchment area of over 0.5 million square kilometers and 629,000 children and adolescents under 18 years of age. Eleven dyads of adolescents and caregivers were enrolled. Five adolescents were male. The mean age of the adolescents was 14.4 ± 2.5 years (range 11.2–18.0). The median distance to our tertiary center was 191 km (range 110–1378 km). Four adolescents lived more than 500 km from our tertiary center. The 11 adolescents had a total of 334 in person visits (mean 30 ± 25) and 86 telemedicine visits (mean 8 ± 7). A ratio of 2:1 telemedicine to in-person visits was favored; with caregivers more in favor of remote care than adolescents. Qualitative analysis found that experiences with telemedicine were distinguished by consultation-specific factors and contextual factors. Contextual factors (travel/cost savings) were valued for telemedicine by adolescents and caregivers. Consultation-specific factors, such as the ability to show the doctor physical symptoms, were more valued during in-person consultations, especially by adolescents. The overall visit type preference was related to the nature of the consultation. For regular check-ups, and for adolescents with less complex needs, participants felt that telemedicine offered a comparable experience to in-person visits. Adolescents with more complex conditions preferred in-person visits. Conclusions Indiscriminate transfer to chronic care predicated on mainly telemedicine approach is not compatible with user expressed attitudes (especially among adolescents). Accurately mapping models of care to these attitudes is an essential determinant of effective management and longer-term engagement with potentially life-long health challenges.

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Section: Introductionmentioning

confidence: 99%

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Qiu

McIntyre

Wile

et al. 2021

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Telemedicine offers a means to provide timely care to patients in remote areas. [5,6] Over a ve year period 652,337 Ontario telemedicine network (OTN) visits were recorded. [6] Recently, there has been a surge of virtual care due to the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Adolescent and Caregiver Attitudes Towards Telemedicine Use in Pediatric Nephrology

Qiu

McIntyre

Wile

et al. 2020

Preprint

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Background: Telemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We aimed at comparing both pediatric patient and caregiver attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness. Methods: This mixed methods cohort study combined patient characteristics and analysis of transcribed structured telephone interviews with both pediatric nephrology patients (11-18 years) and their caregivers. Results: For 11 child-parent dyads, the median distances to tertiary center were 191 km (range 110-1378 km) and 1 km (1-54 km) to remote telemedicine location. Overall a ratio of 2:1 for telemedicine to in-person visits was favored; with caregivers more in favor of remote care than patients. Qualitative analysis found that experiences with telemedicine were distinguished by consultation-specific factors and contextual factors. Contextual factors (travel/cost savings) were valued for telemedicine by patients and caregivers. Consultation-specific factors, such as the ability to show the doctor physical symptoms, were more valued during in-person consultations, especially by patients. The overall visit type preference was related to the nature of the consultation. For regular check-ups, and for patients with less complex needs, participants felt that telemedicine offered a comparable experience to in-person visits. Conclusions: Indiscriminate transfer to chronic care predicated on mainly telemedicine approach is not compatible with user expressed attitudes (especially patients). Accurately mapping models of care to these attitudes is an essential determinant of effective management and longer-term engagement with potentially life-long health challenges.

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Clinical telemedicine utilization in paediatric nephrology at a tertiary care centre

Cited by 2 publications

References 5 publications

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Adolescent and Caregiver Attitudes Towards Telemedicine Use in Pediatric Nephrology

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