Connected Subspecialty Care: Applying Telehealth Strategies to Specific Referral Barriers

Ray, Kristin N.; Kahn, Jeremy M.

doi:10.1016/j.acap.2019.08.002

Cited by 32 publications

(17 citation statements)

References 46 publications

(76 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pediatric gastroenterologists have also used telemedicine to supplement in-person visits and monitor chronic conditions (eg, inflammatory bowel disease) [ 63 ]. Furthermore, due to the limited number of pediatric subspecialty physicians in certain regions, telemedicine referrals are being used to optimize the accessibility of subspecialty resources [ 64 ]. A survey study that was conducted at a pediatric headache clinic in San Francisco, California reported that all included families found telemedicine visits to be more convenient than in-person visits.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine in Pediatrics: Systematic Review of Randomized Controlled Trials

Shah¹,

Badawy²

2021

JMIR Pediatr Parent

123

View full text Add to dashboard Cite

Background Telemedicine modalities, such as videoconferencing, are used by health care providers to remotely deliver health care to patients. Telemedicine use in pediatrics has increased in recent years. This has resulted in improved health care access, optimized disease management, progress in the monitoring of health conditions, and fewer exposures to patients with illnesses during pandemics (eg, the COVID-19 pandemic). Objective We aimed to systematically evaluate the most recent evidence on the feasibility and accessibility of telemedicine services, patients’ and care providers’ satisfaction with these services, and treatment outcomes related to telemedicine service use among pediatric populations with different health conditions. Methods Studies were obtained from the PubMed database on May 10, 2020. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In this review, we included randomized controlled trials from the last 10 years that used a telemedicine approach as a study intervention or assessed telemedicine as a subspecialty of pediatric care. Titles and abstracts were independently screened based on the eligibility criteria. Afterward, full texts were retrieved and independently screened based on the eligibility criteria. A standardized form was used to extract the following data: publication title, first author’s name, publication year, participants’ characteristics, study design, the technology-based approach that was used, intervention characteristics, study goals, and study findings. Results In total, 11 articles met the inclusion criteria and were included in this review. All studies were categorized as randomized controlled trials (8/11, 73%) or cluster randomized trials (3/11, 27%). The number of participants in each study ranged from 22 to 400. The health conditions that were assessed included obesity (3/11, 27%), asthma (2/11, 18%), mental health conditions (1/11, 9%), otitis media (1/11, 9%), skin conditions (1/11, 9%), type 1 diabetes (1/11, 9%), attention deficit hyperactivity disorder (1/11, 9%), and cystic fibrosis–related pancreatic insufficiency (1/11). The telemedicine approaches that were used included patient and doctor videoconferencing visits (5/11, 45%), smartphone-based interventions (3/11, 27%), telephone counseling (2/11, 18%), and telemedicine-based screening visits (1/11, 9%). The telemedicine interventions in all included studies resulted in outcomes that were comparable to or better than the outcomes of control groups. These outcomes were related to symptom management, quality of life, satisfaction, medication adherence, visit completion rates, and disease progression. Conclusions Although more research is needed, the evidence from this review suggests that telemedicine services for the general public and pediatric care are comparable to or better than in-person services. Patients, health care professionals, and caregivers may benefit from using both telemedicine services and traditional, in-person health care services. To maximize the potential of telemedicine, future research should focus on improving patients’ access to care, increasing the cost-effectiveness of telemedicine services, and eliminating barriers to telemedicine use.

show abstract

Section: Discussionmentioning

confidence: 99%

Telemedicine in Pediatrics: Systematic Review of Randomized Controlled Trials

Shah¹,

Badawy²

2021

JMIR Pediatr Parent

123

View full text Add to dashboard Cite

show abstract

“…45 The rapid expansion of telehealth services in response to the COVID-19 pandemic 46 creates new opportunities to overcome geographic barriers to accessing pediatric subspecialty care. 47 Health plan design and telehealth policies should account for the pediatric subspecialty needs of children throughout the United States.…”

Section: Discussionmentioning

confidence: 99%

Growth and changes in the pediatric medical subspecialty workforce pipeline

et al. 2020

View full text Add to dashboard Cite

Background To inform discussions of pediatric subspecialty workforce adequacy and characterize its pipeline, we examined trends in first-year fellows in the 14 American Board of Pediatrics (ABP)-certified pediatric medical subspecialties, 2001–2018. Methods Data were obtained from the ABP Certification Management System. We determined, within each subspecialty, the annual number of first-year fellows. We assessed for changes in the population using variables available throughout the study period (gender, medical school location, program region, and program size). We fit linear trendlines and calculated χ 2 statistics. Results The number of first-year pediatric medical subspecialty fellows increased from 751 in 2001 to 1445 in 2018. Fields with the growth of 3 or more fellows per year were Cardiology, Critical Care, Emergency Medicine, Gastroenterology, Neonatology, and Hematology Oncology ( P value <0.05 for all). The number of fellows entering Adolescent Medicine, Child Abuse, Infectious Disease, and Nephrology increased at a rate of 0.5 fellows or fewer per year. Female American Medical Graduates represented the largest and growing proportions of several subspecialties. Distribution of programs by region and size were relatively consistent over time, but varied across subspecialties. Conclusions The number of pediatricians entering medical subspecialty fellowship training is uneven and patterns of growth differ between subspecialties. Impact The number of individuals entering fellowship training has increased between 2001 and 2018. Growth in the number of first-year fellows is uneven. Fields with the greatest growth: Critical Care, Emergency Medicine, and Neonatology. Fields with limited growth: Adolescent Medicine, Child Abuse, Infectious Disease, and Nephrology. Concerns about the pediatric medical subspecialty workforce are not explained by the number of individuals entering the fellowship.

show abstract

“…Focusing on each sequential step in subspecialty referrals and potential associated barriers, we summarize specific telehealth and technology-enabled strategies to improve access to subspecialty care, including electronic consultations, live interactive telemedicine, storeand-forward telemedicine, tele-mentoring, patient portals, and remote patient monitoring. Intentionally selecting telehealth strategies to target specific subspecialty referral barriers may avoid risks from misapplication of telehealth, may more clearly elevate equitable access as an essential goal within telehealth initiatives, and may also lead to synergistic use of strategies that overcome sequential barriers [25].…”

Section: Discussionmentioning

confidence: 99%

The Effect of MHealth to Increase Mother’s Skill in Children Growth and Development Monitoring During >36–48 and >48–60 Months

Dewi¹,

Rambe²

2020

Proceedings of the 1st International Conference on Science, Health, Economics, Education and Technology (ICoSHEET 2019)

View full text Add to dashboard Cite

Obstacles encountered the lack of implementation of early detection of growth and development of children during ˃36-48 and ˃48-60 months, especially in the development conducted every six months. Children at this age are rarely or never visit Integrated Healthcare Center anymore because the child has entered Early Childhood Education and mother perception that the child has been given compulsory immunization and no need to visit Integrated Healthcare Center. The problem of under five-year growth occurred in Indonesia (2013) is underweight 19.6%, stunting 37.2%, wasting 5.3%, and childhood developmental problems occurred based on the study is 30%. This study aims to assess the effect of the application of MHealth on improving the skills of mothers in monitoring the growth and development of children during ˃36-48 and ˃48-60 months. This study is aimed to analyze the effect of MHealth to increase mother's skill in children's growth development monitoring during ˃36-48 and ˃48-60 months with mothers and midwives for control design in each group by using simple random sampling for sampling technique for maternal and total sampling for midwives. The sample is determined based on age, education, occupation, income, and some children showing no significant difference between the control and treatment groups (p> 0.05). This study uses Quasi-Experimental research design, pre and post-test research design with control group design, which is to assess the effect of MHealth to improve maternal skills in monitoring the growth and development of children during ˃36-48 and ˃48-60 months. Data analysis is taken by Wilcoxon and Mann Whitney. The analysis showed that MHealth effects to increase mother's skill in children's growth development monitoring during ˃36-48 and ˃48-60 months (p<0.05).

show abstract

Connected Subspecialty Care: Applying Telehealth Strategies to Specific Referral Barriers

Cited by 32 publications

References 46 publications

Telemedicine in Pediatrics: Systematic Review of Randomized Controlled Trials

Telemedicine in Pediatrics: Systematic Review of Randomized Controlled Trials

Growth and changes in the pediatric medical subspecialty workforce pipeline

The Effect of MHealth to Increase Mother’s Skill in Children Growth and Development Monitoring During >36–48 and >48–60 Months

Contact Info

Product

Resources

About