The Pacific Asynchronous TeleHealth (PATH) System: Review of 1,000 Pediatric Teleconsultations

Mahnke, C. Becket; Jordan, Christopher P.; Bergvall, Ethan; Person, Donald A.; Pinsker, Jordan E.

doi:10.1089/tmj.2010.0089

Cited by 46 publications

(22 citation statements)

References 6 publications

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“…Several groups have reported improved access and quality with reduced costs for both adult and pediatric cardiology outpatient evaluations. [92][93][94] Such systems aim to replicate the classic "curbside" consultation for remote providers, thereby extending the reach of the specialist into underserved areas. These programs reduce the need for face-to-face evaluations but can increase the overall number of contacts with the specialist, likely as a result of ready specialist access for primary care providers.…”

Section: Teleconsultation and Tele-auscultation In The Office Teleconmentioning

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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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: Teleconsultation and Tele-auscultation In The Office Teleconmentioning

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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“…Previous research has revealed that the appropriateness of referrals to medical subspecialists/surgical specialists is increased and redundancies in evaluative and diagnostic studies are reduced when telemedicine is used. 9,26,30,31 This situation may be particularly true for children, and especially children with special health care needs. The use of "eReferrals," where primary care providers use a Web-based referral and consultation program to discuss a patient's case with a medical subspecialist/surgical specialist before an in-person referral, is another means by which these technologies can be used to increase efficiencies of care.…”

Section: Efficiencies Of Carementioning

confidence: 99%

“…30,[32][33][34][35][36][37] Savings can be realized by a reduction in the duplication of medical tests and examinations, a reduction in the utilization of higher-cost tertiary care centers, and an increased efficiency in referrals and communication. Beyond these savings, there are many societal benefits, including the reduction in travel and patient transport, a reduction in the hours of missed work by the parent/guardian, and a reduction in the frequency of missed school days.…”

Section: Costs Of Carementioning

confidence: 99%

The Use of Telemedicine to Address Access and Physician Workforce Shortages

Rimsza¹,

Hotaling²,

Keown³

et al. 2015

Pediatrics

184

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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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“…[1][2][3][4][5] Telemedicine, the use of electronic information and communication technologies to provide healthcare over a distance, 6 has been used to address this challenge for over 10 years. [4][5][6][7][8][9] There have been previous reports of high satisfaction and perceived high quality of care in pediatric patients receiving pediatric critical care telemedicine consultations in remote emergency departments (EDs) and adult intensive care units (ICUs). 4,10,11 It has also been shown that telemedicine evaluation has good concordance with in-person evaluation of pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Telemedicine Intensivist Support and a Pediatric Hospitalist Program on a Community Hospital

LaBarbera

Ellenby

Bouressa

et al. 2013

Telemedicine and e-Health

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The Pacific Asynchronous TeleHealth (PATH) System: Review of 1,000 Pediatric Teleconsultations

Cited by 46 publications

References 6 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

The Impact of Telemedicine Intensivist Support and a Pediatric Hospitalist Program on a Community Hospital

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