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Medical Care for Children in Rural ERs Improved by Telemedicine

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A new research states that telemedicine consultants can assist rural emergency rooms supply better care to critically ill or injured young patients.

“Rural hospitals and doctors' offices are increasingly using telemedicine to gain access to specialty care. It's a great way to leverage technology to improve the quality of care that we provide,” said senior author of the new study Dr. James Marcin of the University of California, Davis Children's Hospital in Sacramento.

Marcin and his peers collaborated with five different rural hospitals to put in dedicated videoconferencing systems in each rural hospital ER and in the UC Davis Children's Hospital pediatric intensive care unit.

To determine whether the telemedicine consultations were improving care, the researchers observed data on pediatric patients who arrived at the rural ERs in the highest triage category, for the two years prior to installation of the telemedicine modalities and for at least two years following the installation.

They examined records for 320 patients, including 58 who had telemedicine consultations, 63 who had phone consultations and 199 who had no form of consultation. After retrieving and reviewing data that revealed whether a consultation had taken place was removed from the records, two specialists in pediatric critical care separately rated the quality of care provided for each patient.

The overall median of quality of care score was 5.76 on a scale of 1 to 7 for patients who were assigned telemedicine consults, as opposed to 5.38 for patients who received phone consultations and 5.26 for those who were given no consultation.

Moreover, according to data published online in Critical Care Medicine, parents were more content with the care provided to their child when they receiving a telemedicine consultation as opposed to a phone consultation.

Marcin added that real-time videoconferencing supplies consulting doctors with much more information about a patient than a telephone call can.

“We tend to spend more time on the videoconferencing calls than we do on the telephone. When I'm on a videoconferencing call I can see the child moving, I can see the monitors. There's a lot more information that we're gathering when we use videoconferencing than when we're relying on what the doctor is telling us."

Furthermore, Marcin explained how improving the quality of care through telemedicine can sometimes lower other superfluous costs too. For instance an expert consultant can have play a big part in deciding whether a patient may need a helicopter transport to a higher-level trauma center or not.

“Many times if we're able to see the kids, we can say, 'We can use an ambulance, we can help you watch that kid, he can also be admitted locally.’ Sometimes we'll recommend that they go to an intermediate community hospital as opposed to the big city children's hospital,” he said.


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