The Doc’s Not in, but Will See You Now

Telemedicine consultations improved quality of care kids receive in rural emergency rooms

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) A picture is worth a thousand words. What about a video call with a clinical specialist, especially when one is not within driving distance?

The use of telemedicine consultations, in which patients have a video conference call with the doctor, is slowly growing in the US.

Telemedicine can be used by emergency room physicians treating kids to consult with pediatric specialists hundreds of miles away, says a new study.

According to the study, such telemedicine consultations can improve the quality of care delivered to seriously ill children in the emergency room, especially when no pediatric specialists are available for face-to-face consultations.

"Ask your doctor about advances in healthcare technology."

The study was conducted by Madan Dharmar, MBBS, PhD, assistant research professor in the pediatric telemedicine program at the University of California Davis, along with colleagues.

The aim of this study was to examine the impact of emergency room telemedicine consultations compared to other methods of treatment including telephone consultations or treatments without consultations.

The researchers looked at 320 seriously ill or injured children, 17 years old and younger, treated at rural emergency departments between 2003 and 2007.

These emergency departments had videoconferencing equipment to conduct telemedicine consultations. The consultations involved the emergency room physicians, pediatricians at UC Davis Children’s Hospital, nurses, the patients and their parents.

Of the 320 participants, 58 patients received telemedicine consultations, 63 patients received telephone consultations and 199 patients did not receive any specialist consultations.

The researchers examined the quality of care, accuracy of diagnosis, treatment course and overall satisfaction for all the patients.

On analysis of the data, the researchers found that patients who had a telemedicine consultation received significantly higher quality of care scores than those who had a telephone consultation or no consultation.

Parents of children who received telemedicine consultations were more satisfied with the care received than parents of children who received telephone consultations or no consultations.

The researchers also found that rural emergency physicians were more likely to revise their diagnoses and treatment course when they received specialist suggestions over a video conference rather than over the telephone.

"People say a picture is worth a thousand words," said James Marcin, senior study author and professor in the Department of Pediatrics.

"With medicine, video conferencing brings us right to the bedside, allowing us to see what's happening and collaborate with on-site doctors to provide the best possible care to our patients," he said.

Kourosh Parsapour, MD, MBA, founder and CEO of 5plus, a digital health startup, told dailyRx News, “There is a growing shortage of physicians that are trained to treat children, and even fewer that are qualified for critically ill or injured kids. Children make up nearly one-third of all ER visits, but less than 10 percent of the ERs in the US have the necessary supplies or experience to treat a pediatric emergency. This dramatic fact becomes even more exaggerated in rural facilities.”

“Using videoconferencing technology, pediatric telemedicine allows real-time feedback and consultation to ER doctors that wouldn't otherwise have access to pediatric specialists. This study highlights that the use of this technology is not only safe and accepted by parents and providers, but also saves lives,” Dr. Parsapour noted.

The results of this study were published August 8 in Critical Care Medicine.

The study was funded by grants from the Agency for Healthcare Research and Quality, Health Resources and Services Administration-Emergency Medical Services, California Healthcare Foundation grant, and the William Randolph Hearst Foundation. The authors did not disclose any potential conflicts of interest.

Review Date: 
August 16, 2013
Last Updated:
September 5, 2013