Reliability of Telemedicine in the Assessment of Seriously Ill Children

Abstract

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.

Telemedicine Video Visits for Children with Medical Complexity in a Structured Clinical Complex Care Program

“…TMVV’s role in the care of acute and chronic pediatric conditions 5 , 6 has been demonstrated for infants following neonatal intensive care unit discharge, 7 families receiving palliative care services, 8 and children in the emergency department with acute febrile or respiratory illnesses. 6 In addition to these early promising studies, because of improvements in the hospital-to-home transition process, parents have reported preference for TMVV to in-person care. 9 These positive attributes position TMVV to have an outsized impact on CMC cared for within interdisciplinary complex care programs.…”

“…Despite the potential benefits, the literature is limited about the role of TMVV for CMC. Early CMC-specific evidence of feasibility and positive clinical impact has been demonstrated in single-center studies of TMVV 5 , 9 ; however, it remains unclear how best to integrate TMVV into a structured complex care program’s routine care of CMC. 13 Thus, our objective was to describe the implementation of TMVV as part of routine care delivery for CMC receiving care at a tertiary care center-based, structured clinical complex care program.…”

In-Hospital Telehealth Supports Care for Neonatal Patients in Strict Isolation

“…Video telemedicine has been well described for extending care to pediatric patients in geographically remote settings, including pediatric specialty consults such as neurology, genetics, and neonatology. [1][2][3] In these contexts, telemedicine has been demonstrated to be reliable in assessing critically ill children 4 and increases physician confidence in assessments when compared with telephone consults. 5 Typical inpatient care activities in the first 24 hours of admission are the admission history and examination, nighttime rounds by the on-call providers to check on the patient's status and morning interprofessional rounds, that is, conduct-ing interdisciplinary discussions, often at the patient's bedside along with parents or caregivers, with physicians, advanced practice providers (APPs), nurses, respiratory therapists, nutrition, pharmacy, physical and occupational therapy and social work to review the patient's course and decide on a plan of care.…”

Veterinary Telemedicine: A literature review

“…They examined 132 febrile children between the ages of 2 and 36 months and 145 children between the ages of 2 months and 18 years with respiratory distress. For all cases, they found good to excellent agreement between the telemedicine and bedside exams, and they concluded telemedicine is reliable in the assessment of febrile children and those with respiratory distress (Siew et al, 2016).…”