Telemedicine Consultations and Medication Errors in Rural Emergency Departments

Dharmar, Madan; Kuppermann, Nathan; Romano, Patrick S.; Yang, Nikki H.; Nesbitt, Thomas S.; Phan, Jennifer; Nguyen, Cynthia T; Parsapour, Kourosh; Marcin, James P.

doi:10.1542/peds.2013-1374

Cited by 98 publications

(72 citation statements)

References 42 publications

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“…[156][157][158] With telecardiology, pediatric patients can more quickly be evaluated, stabilized, and triaged to determine the need for transport and more advanced treatment or even surgery. 159 Furthermore, telecardiology can be used in all of these settings for case reviews, education, and quality improvement, in conjunction with originating referral sites.…”

Section: Telemedicine In the Intensive Care Settingmentioning

confidence: 99%

“…173,[181][182][183] Although large, randomized trials are lacking, there are increasing acceptance and anecdotal evidence that providing pediatric critical care and telecardiology consultations to remote EDs for children with suspected or known cardiovascular disease is feasible and of clinical utility. 156,158,183 Overall, although more research is needed, it is logical that pediatric telecardiology consultations to rural and underserved EDs through telemedicine can be used to help address disparities in access to specialists and, in doing so, improve the overall quality of care. It is also likely that, because of better care and the reduction in unnecessary transports, telemedicine consultations to rural and underserved EDs can be provided in a cost-efficient manner that reduces the healthcare costs that would otherwise be encountered if telemedicine were not used.…”

Section: Telecardiology In the Edmentioning

confidence: 99%

See 1 more Smart Citation

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Satou¹,

Rheuban²,

Alverson³

et al. 2017

Circulation

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A dvancements in technology and broadband have revolutionized the current practice of medicine. The field of pediatric cardiology is no exception given the need for prompt diagnosis and reliance on cardiac imaging to identify infants and children with potentially life-threatening cardiovascular disease. As the relationship between telemedicine and pediatric cardiology has advanced, it has created a need to develop a broad, comprehensive document reviewing all the various aspects of telemedicine in pediatric cardiology. For more than a decade, a significant body of literature has been published describing individual experiences and practices, yet there remains no comprehensive statement or document summarizing this rapidly advancing field. In an effort to describe the collective experience and to provide structure and guidance for pediatric cardiology practitioners and healthcare providers, we have developed a scientific statement on the use of telemedicine in pediatric cardiology.Specific areas explored in this document include both neonatal and fetal teleechocardiography, implications for training community sonographers, pulse oximetry programs, qualitative improvement and appropriate use criteria initiatives, and remote electrophysiological monitoring. This document also includes teleconsultation and teleausculation, direct-to-consumer and home monitoring programs, and a look into the use of telemedicine and pediatric cardiology in the intensive care setting. Furthermore, a detailed review of the legislative, public policy, and legal aspects of telemedicine is provided, along with financial and reimbursement information.Several terms are used in the literature interchangeably; a brief explanation is provided to help readers of this document. The term telehealth is defined as the use of technology to bridge distances in any aspect of medicine; telemedicine is the specific application of technology to conduct clinical medicine at a distance. The term telecardiology is defined as the broad application of telemedicine in the field of cardiology specifically, and tele-echocardiography is the most common application used within this field. ECHOCARDIOGRAPHY AND TELEMEDICINEEchocardiography is the most commonly used noninvasive cardiovascular imaging modality and is considered to be both safe and cost-effective. Tele-echocardiography can be described as a process in which a provider or a technician obtains cardiovascular ultrasound images from a given patient and these images are subsequently transmitted to an offsite location where a cardiologist can provide further analysis and interpretation. Thus, tele-echocardiography enables expert interpretation and consultation in a rapid and potentially geographically disparate fashion, enabling prompt and accurate decision making involving triage, transport, and therapeutic priorities. Tele-echocardiography is now routinely used across the age and subspecialty spectrum in pediatric cardiology.

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Section: Telemedicine In the Intensive Care Settingmentioning

confidence: 99%

Section: Telecardiology In the Edmentioning

confidence: 99%

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Satou¹,

Rheuban²,

Alverson³

et al. 2017

Circulation

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“…Telemedicine technologies can also increase the overall quality and comprehensiveness of care delivered. 28,29 …”

Section: Quality Of Carementioning

confidence: 99%

The Use of Telemedicine to Address Access and Physician Workforce Shortages

Rimsza¹,

Hotaling²,

Keown³

et al. 2015

Pediatrics

Self Cite

183

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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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“…This allows open communication between patients, physicians, and patient families and caregivers. The same quality of care is capable of being provided in these video consults, according to previous research [18][19]. Rowell et al [18] found that 40 percent of pediatric patients receiving orthopedic consultations via videoconference were discharged after one telehealth consult, and 58 percent of patients did not require a further in-person appointment.…”

Section: Telehealth Capabilities For Remote Consultation and Diagnosismentioning

confidence: 94%

“…In emergent cases, physicians are able to provide timely feedback to families and patients who would otherwise have to incur a great deal of costs on ground or air ambulance [18]. When using telehealth capabilities instead of telephone or email for consult, physicians are also able to provide more accurate diagnoses and thus more appropriate treatment for patients [19]. Physicians are able to consult with pediatric patients through the use of a web camera and a high-quality television screen.…”

Section: Telehealth Capabilities For Remote Consultation and Diagnosismentioning

confidence: 99%

Remote Patient Monitoring and Telemedicine in Neonatal and Pediatric Settings: Scoping Literature Review (Preprint)

Sasangohar¹,

Davis²,

Kash³

et al. 2017

Preprint

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Background: Telemedicine and telehealth solutions are emerging rapidly in healthcare, and have the potential to decrease costs for insurers, providers and patients in various settings. Pediatric populations that require specialty care, are disadvantaged socially or economically, or have chronic health conditions will greatly benefit from results of studies utilizing telemedicine technologies. This paper examines the emerging trends within pediatric populations as part of a systematic literature review and provides a scoping review of the type, extent, and quantity of research available. Objective: This paper aims to examine the role of remote patient monitoring and telemedicine in neonatal and pediatric settings. Findings can be used to identify strengths, weaknesses, and gaps in the field. The identification of gaps will allow for interventions or research to improve healthcare quality and costs. Methods: A systematic literature review is being conducted in order to gather an adequate amount of relevant research for telehealth in pediatric populations. The fields of remote patient monitoring and telemedicine are not yet very well established by the healthcare services sector and definitions vary across healthcare systems, and thus the terms are not always defined similarly throughout the literature. Three databases were scoped for information for this specific review, and 56 articles are included so far. Results: Three major telemedicine trends emerged from the review of 45 relevant papers: remote patient monitoring, teleconsultation, and monitoring patients within the hospital, but without contact, thus decreasing likelihood of infection or other adverse health effects. Conclusion: While the current telemedicine approaches show promise, limited conditions studied and small sample sizes affect generalizability, therefore warranting further research. The information presented can inform healthcare providers of the most widely implemented, studied, and effective forms of telemedicine for patients and their families, and the telemedicine initiatives that are most cost efficient for health systems. While the focus of this review is to summarize some telehealth applications in pediatrics, there are also research studies presented which can inform providers of the importance of data sharing of remote monitoring data between hospitals. Further reports will be developed to inform health systems as the systematic literature review continues.

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Telemedicine Consultations and Medication Errors in Rural Emergency Departments

Cited by 98 publications

References 42 publications

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

The Use of Telemedicine to Address Access and Physician Workforce Shortages

Remote Patient Monitoring and Telemedicine in Neonatal and Pediatric Settings: Scoping Literature Review (Preprint)

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