The use of telemedicine in child sexual abuse evaluations
The use of telemedicine in child sexual abuse evaluations
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DOI：
10.1016/s0145-2134(00)00204-0
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发表时间：
2000-12-01
影响因子：
4.8
通讯作者：
Lukefahr, JL
中科院分区：
文献类型：
--
作者：
Kellogg, ND;Lamb, JL;Lukefahr, JL
目的：描述的优点，缺点和现状的虐待儿童的咨询通过远程医疗networks.Method进行：七个全州远程医疗网络的电话调查的结果进行了报告和讨论的目标，资金，技术支持和专业知识，基础设施和使用程度。远程医疗虐待儿童咨询的质量保证和责任问题也review.Results：虐待儿童远程医疗网络的目标是提供（1）专业知识，主要是在农村地区经验不足的临床医生;（2）同行评议和质量保证的方法，以建立共识的意见，特别是在性虐待案件;和（3）支持专业人员参与情感负担的儿科领域。现有网络遇到的问题包括：（1）设备资金和咨询费用报销;（2）持续的技术支持;（3）临床医生缺乏技术专长、知识或动力;以及（4）缺乏网络基础设施。法律的考虑因素包括跨州咨询的许可豁免、医疗事故的可能性、通过调制解调器线路转发的图像的患者机密性和安全性，以及设备、咨询地点和咨询师在刑事诉讼中的责任。远程医疗咨询为提高虐待儿童评估的护理标准提供了一个独特的机会，但成功与否取决于临床医生的积极性、适当的基础设施，以及持续的资金和技术支持。(C)2000 Elsevier Science Ltd.
Objective: To describe the advantages, disadvantages and current status of child abuse consultations conducted through telemedicine networks.Method: The results of a telephone survey of seven statewide telemedicine networks are reported and discussed with respect to goals, funding, technical support and expertise, infrastructure, and extent of use. Quality assurance and liability issues concerning telemedicine child abuse consultations are also reviewed.Results: The goals of telemedicine networks in child abuse are to provide (1) expertise to less experienced clinicians primarily in rural areas; (2) a method for peer review and quality assurance to build consensus of opinions particularly in sexual abuse cases; and (3) support for professionals involved in an emotionally burdensome area of pediatrics. Problems encountered by existing networks include: (1) funding for equipment and reimbursement for consultation; (2) consistent technical support; (3) clinician lack of technical expertise, knowledge, or motivation; and (4) lack of network infrastructure. Legal considerations include licensure exemptions for consulting across state lines, potential for malpractice, patient confidentiality and security of images forwarded over modem lines, and liability of the equipment, consulting site, and the consultant in criminal proceedings.Conclusions: Telemedicine consultations offer a unique opportunity to raise the standard of care in child abuse evaluations, but success depends on clinician motivation, appropriate infrastructure, and ongoing funding and technical support. (C) 2000 Elsevier Science Ltd.