Pediatric neurosurgery telemedicine clinics: a model to provide care to geographically underserved areas of the United States and its territories
Pediatric neurosurgery telemedicine clinics: a model to provide care to geographically underserved areas of the United States and its territories
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DOI：
10.3171/2016.6.peds16202
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发表时间：
2016-12-01
影响因子：
1.9
通讯作者：
James, Hector E.
中科院分区：
文献类型：
--
作者：
James, Hector E.
目的 作者描述了儿科神经外科远程医疗诊所 (TMC) 的创建、构建和发展，以提供跨越地理、时间、社会和文化障碍的远程医疗服务。 方法 2009 年 7 月，佛罗里达大学 (UF) 儿科神经外科部门收到佐治亚州东南部卫生区（9-2 区）的请求，要求提供 TMC 以满足该地区的需求。佐治亚州儿童医疗服务中心 (CMS) 安装了远程医疗设备和点对点连接。视听连接在佛罗里达大学小儿神经外科办公室进行，维护隐私和 HIPAA（健康保险流通与责任法案）要求。采取了行政措施并记录了 CMS 诊所秘书和护理人员的现场培训。患者预登记和记录是按照佛罗里达大学杰克逊维尔医学院的要求进行的。每月举行一次门诊，CMS 护理人员在患者/父母在场的情况下向儿科神经外科医生介绍相关的临床病史和检查结果。讨论体检结果和诊断研究，并做出管理决策。 结果 第一次 TMC 于 2011 年 8 月举行。截至 2016 年 1 月，总共举行了 40 次 TMC 会议，总共就诊了 43 名患者：13 名患者一次；13 名患者一次； 13例患者两次； 8名患者就诊3次； 2 次共 4 次访问； 2 次共 6 次访问； 2 次共 5 次访问； 7 次访问 2 次； 1 名患者已就诊 8 次。结论 如果其他儿科神经外科中心提供远程医疗服务，则美国大陆及其地区获得儿科神经外科服务有限的地区的儿科患者可以从这种模式中受益。
OBJECTIVE The author describes the creation, structuring, and development of a pediatric neurosurgery telemedicine clinic (TMC) to provide telehealth across geographical, time, social, and cultural barriers.METHODS In July 2009 the University of Florida (UF) Division of Pediatric Neurosurgery received a request from the Southeast Georgia Health District (Area 9-2) to provide a TMC to meet regional needs. The Children's Medical Services (CMS) of the State of Georgia installed telemedicine equipment and site-to-site connectivity. Audiovisual connectivity was performed in the UF Pediatric Neurosurgery office, maintaining privacy and HIPAA (Health Insurance Portability and Accountability Act) requirements. Administrative steps were taken with documentation of onsite training of the secretarial and nursing personnel of the CMS clinic. Patient preregistration and documentation were performed as required by the UF College of Medicine Jacksonville. Monthly clinics are held with the CMS nursing personnel presenting the pertinent clinical history and findings to the pediatric neurosurgeon in the presence of the patient/parents. Physical findings and diagnostic studies are discussed, and management decisions are made.RESULTS The first TMC was held in August 2011. A total of 40 TMC sessions have been held through January 2016, with a total of 43 patients seen: 13 patients once; 13 patients twice; 8 patients for 3 visits; 2 for 4 visits; 2 for 6 visits; 2 for 5 visits; 2 for 7 visits; and 1 patient has been seen 8 times.CONCLUSIONS Pediatric patients in areas of the continental US and its territories with limited access to pediatric neurosurgery services could benefit from this model, if other pediatric neurosurgery centers provide telehealth services.