Clinical Management and Patient Outcomes Among Children and Adolescents Receiving Telemedicine Consultations for Obesity

Shaikh, Ulfat; Cole, Stacey L.; Marcin, James P.; Nesbitt, Thomas S.

doi:10.1089/tmj.2007.0075

Cited by 49 publications

(36 citation statements)

References 40 publications

(40 reference statements)

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“…Remote patient monitoring involves the transmission of personal health and medical data allowing a provider to track healthcare data, such as symptoms, vital signs, and/or laboratory data. Remote patient monitoring often utilizes mobile technologies and has also been shown to successfully result in care with outcomes similar to in-person outcomes for several chronic pediatric conditions, including asthma (26), diabetes (27), and obesity (28). All three of these telemedicine modalities have been used in caring for children with a variety of conditions in a variety of settings (8,16,(29)(30)(31).…”

Section: Overview Of Telemedicinementioning

confidence: 99%

Addressing health disparities in rural communities using telehealth

2015

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The regionalization of pediatric services has resulted in differential access to care, sometimes creating barriers to those living in underserved, rural communities. These disparities in access contribute to inferior healthcare outcomes among infants and children. We review the medical literature on telemedicine and its use to improve access and the quality of care provided to pediatric patients with otherwise limited access to pediatric subspecialty care. We review the use of telemedicine for the provision of pediatric subspecialty consultations in the settings of ambulatory care, acute and inpatient care, and perinatal and newborn care. Studies demonstrate the feasibility and efficiencies gained with models of care that use telemedicine. By providing pediatric subspecialty care in more convenient settings such as local primary care offices and community hospitals, pediatric patients are more likely to receive care that adheres to evidence-based guidelines. In many cases, telemedicine can significantly improve provider, patient, and family satisfaction, increase measures of quality of care and patient safety, and reduce overall costs of care. Models of care that use telemedicine have the potential to address pediatric specialists' geographic misdistribution and address disparities in the quality of care delivered to children in underserved communities.

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Section: Overview Of Telemedicinementioning

confidence: 99%

Addressing health disparities in rural communities using telehealth

2015

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“…3,4 Expert recommendations advocate a staged, family-based approach to pediatric obesity treatment. 5 As obesity levels persist, children and their families should participate in increasingly intensive treatments, culminating in referral to comprehensive interventions and tertiary-care clinics.…”

Section: Introductionmentioning

confidence: 99%

TeleFIT: Adapting a Multidisciplinary, Tertiary-Care Pediatric Obesity Clinic to Rural Populations

Irby

Boles

Jordan

et al. 2012

Telemedicine and e-Health

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Pediatric obesity occurs most frequently in underserved communities where families have difficulty accessing healthcare. Disproportionate obesity rates in rural children denote significant disparities warranting innovative solutions. However, intensive, tertiary-care treatment options outlined in recent expert recommendations may not be available to families living in rural areas. Telemedicine may be useful for providing pediatric obesity treatment to rural families. The aim of this study was to assess the impact of a new outreach program (TeleFIT), which placed telemonitors in four rural satellite clinics to increase access to a pediatric obesity clinic (Brenner Families In Training [FIT]). Before TeleFIT began, of five patients from rural counties enrolled in treatment over a 1-year period, all dropped out by their third visit. Within the first year of TeleFIT, the number of rural patients increased nearly threefold (to 14) and increased again in the second year by an additional 16 new patients (n = 35). Preliminary outcomes indicate comparable attrition rates and improvement in weight status compared with patients in conventional treatment. Telemedicine allows rural families to access intensive obesity treatment from local pediatric offices, eliminating geographic barriers. Systems delivering state-of-the-art care in rural areas have tremendous potential for reducing health disparities in rural populations. Further research is needed to test the efficacy of such interventions.

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“…Lastly, this study is consistent with previous research which has demonstrated that specialty telemedicine consultations can result in improved patient safety. 18,[39][40][41][42][43][44] …”

Section: Discussionmentioning

confidence: 99%

Telemedicine Consultations and Medication Errors in Rural Emergency Departments

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Medication errors occur frequently among pediatric patients, particularly those treated in rural emergency departments (EDs). Although telemedicine has been proposed as a potential solution, there are few data supporting its clinical effectiveness and its effect on medication errors. WHAT THIS STUDY ADDS:The use of telemedicine to provide pediatric critical care consultations to rural EDs is associated with less frequent physician-related ED medication errors among seriously ill and injured children. Therefore, this model of care may improve patient safety in rural hospital EDs. abstract OBJECTIVE: To compare the frequency of physician-related medication errors among seriously ill and injured children receiving telemedicine consultations, similar children receiving telephone consultations, and similar children receiving no consultations in rural emergency departments (EDs). METHODS:We conducted retrospective chart reviews on seriously ill and injured children presenting to 8 rural EDs with access to pediatric critical care physicians from an academic children' s hospital. Physician-related ED medication errors were independently identified by 2 pediatric pharmacists by using a previously published instrument. The unit of analysis was medication administered. The association of telemedicine consultations with ED medication errors was modeled by using hierarchical logistic regression adjusting for covariates (age, risk of admission, year of consultation, and hospital) and clustering at the patient level. RESULTS:Among the 234 patients in the study, 73 received telemedicine consultations, 85 received telephone consultations, and 76 received no specialist consultations. Medications for patients who received telemedicine consultations had significantly fewer physician-related errors than medications for patients who received telephone consultations or no consultations (3.4% vs 10.8% and 12.5%, respectively; P , .05). In hierarchical logistic regression analysis, medications for patients who received telemedicine consultations had a lower odds of physician-related errors than medications for patients who received telephone consultations (odds ratio: 0.19, P , .05) or no consultations (odds ratio: 0.13, P , .05).CONCLUSIONS: Pediatric critical care telemedicine consultations were associated with a significantly reduced risk of physician-related ED medication errors among seriously ill and injured children in rural EDs.

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Clinical Management and Patient Outcomes Among Children and Adolescents Receiving Telemedicine Consultations for Obesity

Abstract: Rural residents report lower likelihood of exercising, and higher rates of obesity, heart disease, and diabetes compared to their urban counterparts. Our goals were to (1)

Cited by 49 publications

References 40 publications

Addressing health disparities in rural communities using telehealth

Addressing health disparities in rural communities using telehealth

TeleFIT: Adapting a Multidisciplinary, Tertiary-Care Pediatric Obesity Clinic to Rural Populations

Telemedicine Consultations and Medication Errors in Rural Emergency Departments

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