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Saidinejad M, Barata I, Foster A, Ruttan TK, Waseem M, Holtzman DK, Benjamin LS, Shahid S, Berg K, Wallin D, Atabaki SM, Joseph MM. The role of telehealth in pediatric emergency care. J Am Coll Emerg Physicians Open 2023; 4:e12952. [PMID: 37124475 PMCID: PMC10131292 DOI: 10.1002/emp2.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 05/02/2023] Open
Abstract
In 2006, the Institute of Medicine published a report titled "Emergency Care for Children: Growing Pains," in which it described pediatric emergency care as uneven at best. Since then, telehealth has emerged as one of the great equalizers in care of children, particularly for those in rural and underresourced communities. Clinicians in these settings may lack pediatric-specific specialization or experience in caring for critically ill or injured children. Telehealth consultation can provide timely and safe management for many medical problems in children and can prevent many unnecessary and often long transport to a pediatric center while avoiding delays in care, especially for time-sensitive and acute interventions. Telehealth is an important component of pediatric readiness of hospitals and is a valuable tool in facilitating health care access in low resourced and critical access areas. This paper provides an overview of meaningful applications of telehealth programs in pediatric emergency medicine, discusses the impact of the COVID-19 pandemic on these services, and highlights challenges in setting up, adopting, and maintaining telehealth services.
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Affiliation(s)
- Mohsen Saidinejad
- The Lundquist Institute for Biomedical Innovation at Harbor UCLATorranceCaliforniaUSA
- David Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Isabel Barata
- Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellNorthwell HealthManhassetNew YorkUSA
| | - Ashley Foster
- Harvard Medical SchoolMassachusetts General HospitalBostonMassachusettsUSA
| | | | - Muhammad Waseem
- Lincoln Medical CenterBronxNew YorkUSA
- Weill Cornell MedicineNew YorkUSA
| | | | - Lee S. Benjamin
- Trinity Health St. Joseph Medical CenterAnn ArborMichiganUSA
| | - Sam Shahid
- American College of Emergency PhysiciansIrvingTexasUSA
| | - Kathleen Berg
- Dell Medical School at the University of TexasAustinTexasUSA
| | - Dina Wallin
- University of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Shireen M. Atabaki
- The George Washington University, School of MedicineChildren's National HospitalWashingtonDistrict of ColumbiaUSA
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Bounthavong M, Shayegani R, Manning JM, Marin J, Spoutz P, Harvey MA, Hoffman JD, Himstreet JE, Kay CL, Freeman BA, Grana A, LD Christopher M. Comparison of virtual to in-person academic detailing on naloxone prescribing rates at three U.S. Veterans Health Administration regional networks. Int J Med Inform 2022; 161:104712. [DOI: 10.1016/j.ijmedinf.2022.104712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/08/2022] [Accepted: 01/28/2022] [Indexed: 12/29/2022]
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Doorenbos AZ, Jang MK, Li H, Lally RM. eHealth Education: Methods to Enhance Oncology Nurse, Patient, and Caregiver Teaching. Clin J Oncol Nurs 2021; 24:42-48. [PMID: 32441697 DOI: 10.1188/20.cjon.s1.42-48] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND eHealth can enhance the delivery of clinical cancer care by offering unique education opportunities for oncology nurses, patients, and family caregivers throughout the cancer trajectory. OBJECTIVES This article reviews eHealth technology that can be applied to oncology education, such as mobile health applications, text messaging, web-based education, and audio- and videoconferencing. METHODS Case studies provide exemplars of eHealth technologies used for delivering oncology education to nurses, patients, and caregivers. FINDINGS By using eHealth technologies to obtain and provide education, oncology nurses are well positioned to improve the lives of patients and caregivers.
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Affiliation(s)
| | | | | | - Robin M Lally
- University of Nebraska Medical Center and Fred and Pamela Buffett Cancer Center
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Affiliation(s)
- Angela L Chandler
- University of Arkansas for Medical Science and Arkansas Children's Hospital, Little Rock, AR
| | - Jared C Beavers
- University of Arkansas for Medical Science and Arkansas Children's Hospital, Little Rock, AR
| | - Richard Whit Hall
- University of Arkansas for Medical Science and Arkansas Children's Hospital, Little Rock, AR
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Telehealth for Pediatric Cardiology Practitioners in the Time of COVID-19. Pediatr Cardiol 2020; 41:1081-1091. [PMID: 32656626 PMCID: PMC7354365 DOI: 10.1007/s00246-020-02411-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/03/2020] [Indexed: 01/18/2023]
Abstract
Due to the COVID-19 pandemic, there has been an increased interest in telehealth as a means of providing care for children by a pediatric cardiologist. In this article, we provide an overview of telehealth utilization as an extension of current pediatric cardiology practices and provide some insight into the rapid shift made to quickly implement these telehealth services into our everyday practices due to COVID-19 personal distancing requirements. Our panel will review helpful tips into the selection of appropriate patient populations and specific cardiac diagnoses for telehealth that put patient and family safety concerns first. Numerous practical considerations in conducting a telehealth visit must be taken into account to ensure optimal use of this technology. The use of adapted staffing and billing models and expanded means of remote monitoring will aid in the incorporation of telehealth into more widespread pediatric cardiology practice. Future directions to sustain this platform include the refinement of telehealth care strategies, defining best practices, including telehealth in the fellowship curriculum and continuing advocacy for technology.
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Harding B, Webber C, Rühland L, Dalgarno N, Armour C, Birtwhistle R, Brown G, Carroll JC, Flavin M, Phillips SP, MacKenzie JJ. Bridging the gap in genetics: a progressive model for primary to specialist care. BMC MEDICAL EDUCATION 2019; 19:195. [PMID: 31185964 PMCID: PMC6558677 DOI: 10.1186/s12909-019-1622-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 05/22/2019] [Indexed: 05/15/2023]
Abstract
BACKGROUND The rapid expansion of genetic knowledge, and the implications for healthcare has resulted in an increased role for Primary Care Providers (PCPs) to incorporate genetics into their daily practice. The objective of this study was to explore the self-identified needs, including educational needs, of both urban and rural Primary Care Providers (PCPs) in order to provide genetic care to their patients. METHODS Using a qualitative grounded theory approach, ten key informant interviews, and one urban and two rural PCP focus groups (FGs) (n = 19) were conducted. All PCPs practiced in Southeastern Ontario. Data was analyzed using a constant comparative method and thematic design. The data reported here represent a subset of a larger study. RESULTS Participants reported that PCPs have a responsibility to ensure patients receive genetic care. However, specific roles and responsibilities for that care were poorly defined. PCPs identified a need for further education and resources to enable them to provide care for individuals with genetic conditions. Based on the findings, a progressive stepped model that bridges primary and specialty genetic care was developed; the model ranged from PCPs identifying patients with genetic conditions that they could manage alone, to patients who they could manage with informal or electronic consultation to those who clearly required specialist referral. CONCLUSIONS PCPs identified a need to integrate genetics into primary care practice but they perceived barriers including a lack of knowledge and confidence, access to timely formal and informal consultation and clearly defined roles for themselves and specialists. To address gaps in PCP confidence in providing genetic care, interventions that are directed at accessible just-in-time support and consultation have the potential to empower PCPs to manage patients' genetic conditions. Specific attention to content, timing, and accessibility of educational interventions is critical to address the needs of both urban and rural PCPs. A progressive framework for bridging primary to specialty care through a 'stepped' model for providing continuing medical education, and genetic care can was developed and can be used to guide future design and delivery of educational interventions and resources.
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Affiliation(s)
- Brittany Harding
- Department of Pediatrics, McMaster University, Hamilton, Ontario Canada
| | - Colleen Webber
- Queen’s University, 99 University Avenue, Kingston, Ontario K7L 3N6 Canada
| | - Lucia Rühland
- Queen’s University, 99 University Avenue, Kingston, Ontario K7L 3N6 Canada
| | - Nancy Dalgarno
- Botterell Hall, Queen’s University, 18 Stuart Street, Kingston, Ontario K7L 3N6 Canada
| | - Christine Armour
- Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1 Canada
| | | | - Glenn Brown
- Centre for Studies in Primary Care, Queen’s University, 220 Bagot Street, P.O.#8888, Kingston, Ontario K7L 5E9 Canada
| | - June C. Carroll
- Department of Family and Community Medicine, Granovsky Gluskin Family Medicine Centre, Mount Sinai Hospital, University of Toronto, 60 Murray St., 4th Floor, Box 25, Toronto, Ontario M5T 3L9 Canada
| | - Michael Flavin
- Department of Pediatrics, Faculty of Health Sciences, Queen’s University, Kingston, Ontario Canada
| | - Susan P. Phillips
- Centre for Studies in Primary Care, Queen’s University, 220 Bagot Street, P.O.#8888, Kingston, Ontario K7L 5E9 Canada
| | - Jennifer J. MacKenzie
- Department of Pediatrics, McMaster Children’s Hospital, 1280, Main St. West, 3N11-G, Hamilton, Ontario L8S 4K1 Canada
- Department of Medicine, Queen’s University, Kingston, Ontario Canada
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Abstract
BACKGROUND The current study involves a national survey of healthcare providers who offer services for individuals with a variety of neurological conditions. It aims to describe the provision of health and community-based services as well as the admission criteria, waitlist practices, and referral sources of these services. METHODS An online survey was directed at administrators/managers from publicly funded hospital programs, long-term care homes, and community-based healthcare provider agencies that were believed to be providing information and/or services to patients with a variety of neurological conditions. RESULTS Approximately 60% (n=254) of respondents reported providing services in either urban/suburban areas or rural/remote areas only, whereas the remaining 40% (n=172) provided services regardless of patient location. A small proportion of respondents reported providing services for individuals with dystonia (28%), Tourette syndrome (17%), and Rett syndrome (13%). There was also a paucity of diverse healthcare professionals across all institutions, but particularly mental healthcare professionals in hospitals. Lastly, the majority of respondents reported numerous exclusion criteria with regard to service provision, including prevalent comorbid conditions. CONCLUSIONS If the few services provided for these neurological patient populations exclude common comorbidities, it is likely that there will be no other place for these individuals to seek care.
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Abstract
OBJECTIVES The transfer of children from community emergency departments (EDs) to tertiary care pediatric EDs for investigations, interventions, or a second opinion is common. In order to improve health care system efficiency, we must have a better understanding of this population and identify areas for education and capacity building. METHODS We conducted a retrospective chart review of all patients (aged 0-17 years) who were transferred from community ED to a pediatric ED from November 2013 to November 2014. The primary outcome was the frequency of referred patients who were discharged home from the pediatric ED. RESULTS Two hundred four patients were transferred from community EDs in the study period. One hundred thirteen children (55.4%) were discharged home from the pediatric ED. Presence of inpatient pediatric services (P = 0.04) at the referral hospital and a respiratory diagnosis (P = 0.03) were independently associated with admission to the children's hospital. In addition, 74 patients (36.5%) had no critically abnormal vital signs at the referral hospital and did not require any special tests, interventions, consultations, or admission to the children's hospital. Younger age (P = 0.03), lack of inpatient pediatric services (P = 0.04), and a diagnosis change (P = 0.03) were independently associated with this outcome. CONCLUSIONS More than half of patients transferred to the pediatric tertiary care ED did not require admission, and more than one third did not require special tests, interventions, consults, or admission. Many of these patients were likely transferred for a second opinion from a pediatric emergency medicine specialist. Education and real-time videoconferencing consultations using telemedicine may help to reduce the frequency of transfers for a second opinion and contribute to cost savings over the long term.
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Abstract
This article examines the current role of telehealth as a tool in the delivery of pediatric health care. It defines telemedicine and telehealth and provides an overview of different types of telehealth services. The article then explores the potential of telehealth to improve pediatric health care quality and safety through increased access to care, enhanced communication, expanded educational opportunities, and better resource utilization. It also discusses current challenges to the implementation of telehealth, including technological, financial, and licensing barriers, as well as provider, patient, and legal concerns.
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Affiliation(s)
- Levon Utidjian
- Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, 3535 Market Street, Suite 1024, Room 1080, Philadelphia, PA 19104, USA.
| | - Erika Abramson
- Department of Pediatrics, Weill Cornell Medicine, 525 E 68th Street, Rm M610A, New York, NY 10065, USA; Healthcare Policy and Research, Weill Cornell Medicine, 402 East 67th Street, New York, NY, 10065, USA
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Marcin JP, Rimsza ME, Moskowitz WB. The Use of Telemedicine to Address Access and Physician Workforce Shortages. Pediatrics 2015; 136:202-9. [PMID: 26122802 DOI: 10.1542/peds.2015-1253] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The use of telemedicine technologies by primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists (henceforth referred to as "pediatric physicians") has the potential to transform the practice of pediatrics. The purpose of this policy statement is to describe the expected and potential impact that telemedicine will have on pediatric physicians' efforts to improve access and physician workforce shortages. The policy statement also describes how the American Academy of Pediatrics can advocate for its members and their patients to best use telemedicine technologies to improve access to care, provide more patient- and family-centered care, increase efficiencies in practice, enhance the quality of care, and address projected shortages in the clinical workforce. As the use of telemedicine increases, it is likely to impact health care access, quality, and education and costs of care. Telemedicine technologies, applied to the medical home and its collaborating providers, have the potential to improve current models of care by increasing communication among clinicians, resulting in more efficient, higher quality, and less expensive care. Such a model can serve as a platform for providing more continuous care, linking primary and specialty care to support management of the needs of complex patients. In addition, telemedicine technologies can be used to efficiently provide pediatric physicians working in remote locations with ongoing medical education, increasing their ability to care for more complex patients in their community, reducing the burdens of travel on patients and families, and supporting the medical home. On the other hand, telemedicine technologies used for episodic care by nonmedical home providers have the potential to disrupt continuity of care and to create redundancy and imprudent use of health care resources. Fragmentation should be avoided, and telemedicine, like all primary and specialty services, should be coordinated through the medical home.
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Abstract
Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine's current use bears testimony to its effectiveness and potential. Telemedicine's widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits.
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Lowery CL, Bronstein JM, Benton TL, Fletcher DA. Distributing medical expertise: the evolution and impact of telemedicine in arkansas. Health Aff (Millwood) 2015; 33:235-43. [PMID: 24493766 DOI: 10.1377/hlthaff.2013.1001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Arkansas's telemedicine system has evolved since 2003 from a support mechanism for high-risk pregnancy consultations to an initiative that spans medical specialties, including asthma care, pediatric cardiology, gynecology, and mental health. The system has also expanded care to diverse populations, including incarcerated women and people with HIV/AIDS. This article describes the system's evolution, organization, and diverse activities. It also shows how telemedicine can have a positive impact on a rural state and how such a state can become an engine for change regionally. The Arkansas telemedicine system faced classic challenges to uptake and function, in building and sustaining funding, in obtaining insurance reimbursement for services, and in educating patients and providers. The system's impacts on health outcomes and medical practice culture have also reached beyond patient care and provider support. The existing yet continually evolving telemedicine infrastructure and partnerships in Arkansas will respond to the state's inevitable health care reform adaptations from the Affordable Care Act and could provide direction for other states seeking to adopt or expand their telemedicine efforts.
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Kim EW, Teague-Ross TJ, Greenfield WW, Williams DK, Kuo D, Hall RW. Telemedicine collaboration improves perinatal regionalization and lowers statewide infant mortality. J Perinatol 2013; 33:725-30. [PMID: 23579490 PMCID: PMC4138978 DOI: 10.1038/jp.2013.37] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 02/15/2013] [Accepted: 02/15/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We assessed a telemedicine (TM) network's effects on decreasing deliveries of very low birth weight (VLBW, <1500 g) neonates in hospitals without Neonatal Intensive Care Units (NICUs) and statewide infant mortality. STUDY DESIGN This prospective study used obstetrical and neonatal interventions through TM consults, education and census rounds with 9 hospitals from 1 July 2009 to 31 March 2010. Using a generalized linear model, Medicaid data compared VLBW birth sites, mortality and morbidity before and after TM use. Arkansas Health Department data and χ(2) analysis were used to compare infant mortality. RESULT Deliveries of VLBW neonates in targeted hospitals decreased from 13.1 to 7.0% (P=0.0099); deliveries of VLBW neonates in remaining hospitals were unchanged. Mortality decreased in targeted hospitals (13.0% before TM and 6.7% after TM). Statewide infant mortality decreased from 8.5 to 7.0 per 1000 deliveries (P=0.043). CONCLUSION TM decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality.
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Affiliation(s)
- Elizabeth W. Kim
- Department of Pediatrics/Neonatology, College of Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas
| | - Terri J. Teague-Ross
- Department of Obstetrics and Gynecology, Center for Distance Health, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - William W. Greenfield
- Department of Obstetrics and Gynecology, Center for Distance Health, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - D. Keith Williams
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Dennis Kuo
- Department of Obstetrics and Gynecology, Center for Distance Health, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Richard W. Hall
- Department of Pediatrics/Neonatology, College of Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas
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Meyer BC, Clarke CA, Troke TM, Friedman LS. Essential telemedicine elements (tele-ments) for connecting the academic health center and remote community providers to enhance patient care. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:1032-1040. [PMID: 22722348 DOI: 10.1097/acm.0b013e31825cdd3a] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The authors draw on their experience with the University of California, San Diego Medical Center's successful enterprise-level clinical telemedicine program to present a paradigm for other academic health centers (AHCs) that wish to develop such a program. They detail key telemedicine program elements, or "tele-ments," that they consider essential to the development of a centralized, structured telemedicine program and relevant to the development of smaller programs. These tele-ments include an overall organizational vision, a centralized telemedicine infrastructure, telemedicine-specific policies and procedures, medical record documentation, relationships between the AHC clinical hub and its remote (spoke) partners, identification of and training for specialty providers, a business plan based on service agreements and/or insurance billing, and licensure/privileging. They discuss the importance of delaying equipment purchases until a plan is in place for sustaining the telemedicine enterprise and of establishing measures to define success at the outset of program development. In addition, they detail the benefits and concerns associated with telemedicine, provide a comprehensive listing of the roles and responsibilities of providers and staff involved in all aspects of telemedicine, and share samples of their program's informed consent forms and workflow checklists. Their goal is to offer support and guidance to other AHCs entering the telemedicine arena, enabling them to replicate key elements of a successful, enterprise-wide telemedicine infrastructure.
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Affiliation(s)
- Brett C Meyer
- University of California, San Diego (UCSD), San Diego, CA 92103-8466, USA.
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Abstract
Providing long-term multidisciplinary care for cleft lip/palate is a challenge for international humanitarian organizations that perform surgery across borders. The use of telemedicine as a means of evaluating speech in patients with cleft lip/palate has not been studied previously. We looked at determining whether a speech evaluation performed by a speech-language pathologist (SLP) using telemedicine would be equivalent to a speech evaluation performed in-person, in an international setting between Tijuana, Mexico and San Diego, CA. Spanish-speaking SLPs developed an informal protocol to evaluate several speech characteristics. Patients were simultaneously evaluated by 2 SLPs, one in-person in Tijuana and the other over telemedicine videoconference from San Diego, CA. In addition, we obtained data regarding the parents experience with telemedicine through a satisfaction survey. Results showed no statistically significant differences between the 2 methods of speech evaluation, particularly in oral muscle tone, resonance, lingual lateralization, oral pressure, and dentition. The satisfaction survey showed family satisfaction with the speech evaluation performed using telemedicine. Thus, telemedicine represents an effective medium for conducting speech assessment in patients with cleft lip/palate, allowing for increased access to care for underserved populations.
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Doorenbos AZ, Kundu A, Eaton LH, Demiris G, Haozous EA, Towle C, Buchwald D. Enhancing access to cancer education for rural healthcare providers via telehealth. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2011; 26:682-686. [PMID: 21336979 PMCID: PMC3199344 DOI: 10.1007/s13187-011-0204-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Healthcare providers serving rural populations face numerous barriers to accessing educational programming. Difficulties accessing continuing professional education contribute to the challenges of providing comprehensive health care in the rural setting. Telehealth can inform and educate rural providers about changes in medicine and evidence-based practices, both of which may help them provide quality care. The Native People for Cancer Control Telehealth Network used telehealth technology to deliver a cancer education series in 2008 and 2009 to Washington and Alaska rural healthcare providers who treated American Indians and Alaska Native people. Customizing presentation content to providers' educational needs encouraged attendance. Evaluation indicated videoconferencing technology was positively received for delivery of the educational sessions. This series demonstrated videoconferencing was a satisfactory means of delivering real-time, interactive cancer educational programming to providers who might not otherwise have access to such programs.
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Affiliation(s)
- Ardith Z Doorenbos
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA, USA.
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Hall RW, Hall-Barrow J, Garcia-Rill E. Neonatal regionalization through telemedicine using a community-based research and education core facility. Ethn Dis 2010; 20:S1-140. [PMID: 20521402 PMCID: PMC3323108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION Although regionalization of neonatal intensive care is associated with improved outcomes, implementation has been difficult because of increased deliveries of sicker neonates in smaller nurseries. Telemedicine has been used successfully for medical care and education but it has never been utilized to modify patterns of delivery in an established state network. METHODS The Community Based Research and Education Core Facility of the Center for Translational Neuroscience established a network of 15 telemedicine units with real-time teleconferencing and diagnostic quality imaging, called Telenursery, placed in neonatal intensive care units, using T1 lines to link these units with a large academic neonatal practice. Weekly educational conferences were conducted to establish guidelines for obstetrical, neonatal and pediatric care in a program called PedsPLACE (Physician Learning and Collaborative Education). Patterns of delivery were assessed through a linked Medicaid database before and after the Telenursery initiative to determine if the most at-risk neonates were transferred to the academic perinatal center for delivery. Clinician satisfaction with the PedsPLACE educational conference was high as assessed through written survey instruments. RESULTS Medicaid deliveries at the regional perinatal centers increased from 23.8% before the intervention to 33% in neonates between 500 and 999 grams (P < .05) and was unchanged in neonates between 2001-2500 grams. CONCLUSION Telemedicine is an effective way to translate evidence-based medicine into clinical care when combined with a general educational conference. Patterns of deliveries appear to be changing so that those newborns at highest risk are being referred to the regional perinatal centers.
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Affiliation(s)
- R Whit Hall
- Center for Translational Neuroscience, Department of Pediatrics, Neonatology, University of Arkansas for Medical Sciences, USA.
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Smith CE, Fontana-Chow K, Boateng BA, Azzie G, Pietrolungo L, Cheng-Tsallis A, Golding F, Tallett S. Tele-education: linking educators with learners via distance technology. Pediatr Ann 2009; 38:550-6. [PMID: 19968192 DOI: 10.3928/00904481-20090918-10] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Christopher E Smith
- Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, AR 72202-3591, USA
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