Telemedicine in pediatric surgery

Harting, Matthew T.; Wheeler, Austin; Ponsky, Todd A.; Nwomeh, Benedict C.; Snyder, Charles L.; Bruns, Nicholas E.; Lesher, Aaron; Pandya, Samir; Dickie, Belinda; Shah, Sohail R.; Informatics, Apsa

doi:10.1016/j.jpedsurg.2018.04.038

Cited by 58 publications

(39 citation statements)

References 24 publications

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“…Telemedicine is defined by The Institute of Medicine as "the use of electronic information and communications technologies to provide and support health care when distance separates participants." 1,2 It has allowed for rapid access to shared and remote medical expertise, no matter where the patient or relevant information is located. 3 Essentially, telemedicine has allowed the utilization of telecommunications for the purpose of diagnosing and treating patients in remote locations.…”

Section: Introductionmentioning

confidence: 99%

“…8 As such, telemedicine has been applied to a wide array of surgical specialties, including, endocrine surgery, orthopaedics, ENT, colorectal surgery, vascular surgery, neurosurgery, transplant, oncological surgery, urology, and pediatric and plastic surgery. 2,5,9 In today's current world of COVID-19, spinal surgeons are in need of accurate, validated, and comprehensive virtual physical exams because nonessential visits have been postponed or canceled in many parts of the world. In order for a spine surgeon to properly perform a telemedicine visit, a virtual spine physical exam that is both reliable and practical must be available for use.…”

Section: Introductionmentioning

confidence: 99%

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Physical Examination of the Spine Using Telemedicine: A Systematic Review

Piche

Butt

Ahmady

et al. 2020

Global Spine Journal

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Study Design: This is a systematic review. Objective: To systematically review (1) the reliability of the physical examination of the spine using telehealth as it pertains to spinal pathology and (2) patient satisfaction with the virtual spine physical examination. Methods: We searched EMBASE, PubMed, Medline Ovid, and SCOPUS databases from inception until April 2020. Eligible studies included those that reported on performing a virtual spine physical examination. Two reviewers independently assessed all potential studies for eligibility and extracted data. The primary outcome of interest was the reliability of the virtual spine physical exam. Secondary outcomes of interest were patient satisfaction with the virtual encounter. Results: A total of 2321 studies were initially screened. After inclusion criteria were applied, 3 studies (88 patients) were included that compared virtual with in-person spine physical examinations. These studies showed acceptable reliability for portions of the low back virtual exam. Patient satisfaction surveys were conducted in 2 of the studies and showed general satisfaction (>80% would recommend). Conclusions: These results suggest that the virtual spine examination may be comparable to the in-person physical examination for low back pain, though there is a significant void in the literature regarding the reliability of the physical examination as it pertains to specific surgical pathology of the spine. Because patients are overall satisfied with virtual spine assessments, validating a virtual physical examination of the spine is an important area that requires further research.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Physical Examination of the Spine Using Telemedicine: A Systematic Review

Piche

Butt

Ahmady

et al. 2020

Global Spine Journal

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“…Technology has exponentially expanded in the last decade, increasing the ability of patients to access a healthcare professionals worldwide (Harting et al, 2019). Telemedicine has been used successfully in many areas of care including diagnosis, treatment, disease prevention, continuous education of healthcare professionals and patients, and research (Vrecar, Hristovski, & Peterlin, 2017).…”

Section: Introductionmentioning

confidence: 99%

An international telemedicine program for diagnosis of genetic disorders: Partnership of pediatrician and geneticist

Mena

Mendoza

Peña³

et al. 2020

American J of Med Genetics Pt C

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There is a shortage of genetics providers worldwide and access is limited to large academic centers. Telemedicine programs can facilitate access to genetic services to patients living in remote locations. The goal of this study was to improve access to genetic services in the Dominican Republic by creating a partnership model between a pediatrician and geneticist. This approach has been used within the United States but not in the setting of two different countries, healthcare system, and cultures. Patients were referred to the Centro de Obstetricia y Ginecologia program if a syndromic or genetic etiology was suspected by their local provider. Pediatrician first evaluated all patients prior to telemedicine appointment to review family and medical history. All genetic visits were scheduled within 2 weeks of referral in collaboration with telehealth program at Cincinnati Children's Hospital Medical Center. A total of 66 individuals were evaluated during a period of 5 years. Fifty-seven individuals underwent genetic studies, and a molecular diagnosis was made in 39 individuals. Exome sequencing was the most common first line test when differential diagnosis was broad (n = 40). The most common inheritance was autosomal recessive in 15 individuals, followed by 13 individuals with autosomal dominant disorders, 7 individuals X-linked disorders, and 4 individuals with chromosomal abnormalities. This study provides data to support utility of geneticist and pediatrician partnership to provide outreach telemedicine diagnostics and management services for rare diseases in an international setting.

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“…It has been successfully implemented for pediatric care [1] , stroke care [2] , diabetes management [3] , and intensive care management [4] . There is also increased interest in implementation for pediatric surgery [5] in the United States, and internationally it has been implemented with excellent success [6] .…”

Section: Introductionmentioning

confidence: 99%

“…It has been utilized for postoperative visits [7] and breast care [8] . Guidelines have not been created for the use of telemedicine in general surgery [5] . The only published study utilizing telemedicine for general surgery consultation in a clinic was conducted by Cain et al [9] .…”

Section: Introductionmentioning

confidence: 99%

Pilot study of telemedicine for the initial evaluation of general surgery patients in the clinic and hospitalized settings

Schroeder

2019

Surgery Open Science

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Background Telemedicine has had limited implementation for general surgery. The purpose of this study was to evaluate telemedicine for the initial evaluation of patients in the clinic and hospital settings. Methods Synchronous telemedicine consults were conducted by a single surgeon to a rural hospital and clinic. Reasons for consult, adequacy of consult, days saved by telemedicine consult compared to standard practice, correlation of telemedicine and in-person physical exam, and number of patients who required procedures were evaluated. Results On average, patients were evaluated 7.4 days more rapidly than if the consult had been done by our standard practice. Telemedicine was adequate for all patients in this study. Conclusions This is the first study using telemedicine for the initial consult of general surgery patients in the hospitalized and clinic setting in North America. The physical exam remains an important component of the general surgery evaluation, and special attention must be considered when structuring the telemedicine program. Telemedicine is an effective and expedient way to provide consultation for general surgery patients. Further study is needed to determine which general surgery issues are not amendable to telemedicine consultation, and to determine other surgical specialties that could utilize telemedicine in their practice.

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Telemedicine in pediatric surgery

Cited by 58 publications

References 24 publications

Physical Examination of the Spine Using Telemedicine: A Systematic Review

Physical Examination of the Spine Using Telemedicine: A Systematic Review

An international telemedicine program for diagnosis of genetic disorders: Partnership of pediatrician and geneticist

Pilot study of telemedicine for the initial evaluation of general surgery patients in the clinic and hospitalized settings

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