Premium
Pediatric Telemedicine Use in United States Emergency Departments
Author(s) -
Brova Monica,
Boggs Krislyn M.,
Zachrison Kori S.,
Freid Rachel D.,
Sullivan Ashley F.,
Espinola Janice A.,
Boyle Tehnaz P.,
Camargo Carlos A.
Publication year - 2018
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.13629
Subject(s) - telemedicine , medicine , receipt , staffing , medical emergency , family medicine , health care , nursing , world wide web , computer science , economics , economic growth
The receipt of remote clinical care for children via telecommunications (pediatric telemedicine) appears to improve access to and quality of care in U.S. emergency departments ( ED s), but the actual prevalence and characteristics of pediatric telemedicine receipt remain unclear. We determined the prevalence and current applications of pediatric telemedicine in U.S. ED s, focusing on ED s that received telemedicine from clinicians at other facilities. Methods We surveyed all 5,375 U.S. ED s to characterize emergency care in 2016. We then randomly surveyed 130 (39%) of the 337 ED s who reported receiving pediatric telemedicine. The second survey was administered by phone to ED directors primarily. It confirmed that the ED received pediatric telemedicine services in 2017 and asked about ED staffing and the nature, purpose, and concerns with pediatric telemedicine implementation. Results The first survey (4,507/5,375, 84% response) showed that 337 (8%) ED s reported receiving pediatric telemedicine. Among the randomly sampled ED s completing the second survey (107/130, 82% response), 96 (90%) confirmed 2016 use and 89 (83%) confirmed 2017 use. Reasons for discontinuation included technical and scheduling concerns. Almost all who confirmed their pediatric telemedicine use in 2017 also reported 24/7 availability (98%). The most widely reported use was for patient placement and transfer coordination (80%). Many ED s (39%) reported no challenges with implementing pediatric telemedicine and described its utility. However, the most frequently reported challenges were process concerns (30%), such as concerns about slowing or interrupting providers’ work flow and technological concerns (14%). Conclusion Few ED s receive telemedicine for the delivery of pediatric emergency care nationally. Among ED s that do use telemedicine for pediatric care, many report process concerns. Addressing these barriers through focused education or interventions may support ED s in further developing and optimizing this technological adjunct to pediatric emergency care.