Fast, cheap and feasible: Implementation of pediatric telemedicine in a public hospital during the Covid-19 pandemic

Abstract

Objective In Brazil, telemedicine was allowed as an exception during the coronavirus disease (COVID-19) pandemic. Despite its recognized value and availability, telemedicine is not universally used, suggesting that some barriers prevent its adoption and acceptance within the community. This study aims to describe the implementation of a low-cost telemedicine service in a pediatric hospital in Brazil. Method Retrospective descriptive study reporting the first three months (April to June 2020) of the experience of implementing a low-cost telemedicine emergency care program in a public tertiary hospital. The service was available to patients up to 18 years of age enrolled in this hospital. A tool for assessing the severity of the patient was developed, the aim of standardizing the procedure, while maintaining quality and safety. Guardian's satisfaction was assessed with a questionnaire sent after teleconsultations. Results 255 teleconsultations were carried out with 140 different patients. Of the total consultations, 182 were from 99 patients that had performed the Real-Time Polymerase Chain Reaction (RT-PCR) test for the new coronavirus (SARS-Cov-2) or had direct contact with a person known to be positive for COVID-19. Only 26 (14%) were referred to an in-person consultation. No deaths, adverse events or delayed diagnosis were recorded. 86% of the patients who answered the satisfaction questionnaire were satisfied and 92% would use telemedicine again. Conclusion This study presents an innovative implementation of a telemedicine program in a public and exclusively pediatric tertiary service, serving as a reference for future implementation in other public services in Brazil and developing countries.

Higher Acceptance of Videotelephonic Counseling Formats in Psychosomatic Medicine in Times of the COVID-19 Pandemic

“…Regarding "assessment of therapeutic contact" general acceptance and high satisfaction were found with all the counseling formats also in line with similar studies that report the "evaluation of the therapeutic contact" in both telecounseling and face-to-face contact as satisfactory, trusting and appreciative (23,24). Here it should be noted that the majority of the sessions in the study, were individual sessions and did not take place in the context of therapy.…”

How to incorporate telemedicine in medical residency: A Brazilian experience in pediatric emergency

“…The PATMHO is pioneer in offering telemedicine in a public and exclusively pediatric tertiary service. 6 The present study demonstrates an avant-garde telemedicine training initiative for pediatric residents, focusing on pediatric emergencies. Telemedicine is probably one of the legacies of the COVID-19 pandemic 14 , 17 and we observed that the pediatric residents of our service already recognize the importance of learning more about virtual care.…”

“…Also, most consultations involved reassessments of face-to-face evaluations with similar complaints of respiratory problems during the pandemic. 6 We considered that there were few cases/residents (approximately 9 per semester) due to the service being new and still in the initial years of implementation. Even so, residents considered that there was no impairment in learning.…”

“…In April 2020, the Hospital Telemedicine Emergency Care Program (PATMHO ‒ “Pronto Atendimento em Telemedicina Hospitalar”, in Portuguese) started at the Integrated Pediatric Reference Emergency Center of our hospital. 6 …”

Present and future of telemedicine for pediatric care: an Italian regional experience

“…Economic impact of telehome care will also be evaluated. As reported, home hospitalization allows cost optimization, both structural and personnel expenses [ 14 – 17 ]; prospectively telehomecare in the pediatric field can cost up to 9% less than standard care [ 14 ].…”