Virtual Pediatric Emergency Department Telehealth Network Program: A Case Series
Virtual Pediatric Emergency Department Telehealth Network Program: A Case Series
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DOI：
10.1097/pec.0000000000002119
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发表时间：
2020-05-01
影响因子：
1.4
通讯作者：
Sapien, Robert
中科院分区：
文献类型：
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作者：
Cotton, James;Bullard-Berent, Jeffrey;Sapien, Robert
生活在农村、服务水平低下地区的儿科患者获得医疗服务的机会减少。有一个缺乏研究描述使用远程医疗（TM）的一般儿科急诊医学（PEM）。2013年，我们建立了儿童就绪虚拟儿科急诊科远程医疗网络（CR-VPED），这是一项PEM TM咨询服务，服务于新墨西哥州的农村医院。本文的目的是描述我们的经验6年（2013-2018）。方法我们描述了建立CR-VPED远程医疗网络的过程。我们审查了2013年6月22日至2018年9月6日完成的所有TM咨询。在我们的审查中，我们专注于患者的人口统计数据，医疗投诉，转移状态，转介提供者的类型，以及遇到的问题与每个TM consultation.Results之间，我们一共有58 PEM TM咨询2013年6月22日，2018年9月6日。所有咨询都是在12个既定地点中的6个地点进行的。大多数TM咨询（71%; 41/58）是与印度卫生服务网站。在所有TM咨询中，患者年龄范围为30天至17岁（平均54个月;中位数32个月）。只有26%（15/58）的TM咨询患者被转移到三级护理医院。主诉和诊断混杂在一起。皮疹是最常见的主诉（24%; 14/58）。转诊提供者有多种，其中家庭医生最常见（31%; 18/58）。常见的技术问题是没有正确记录的遭遇到电子病历（12%; 7/58）和困难登录到CR-VPED远程医疗网络（9%; 5/58）。结论以前的研究已经调查了使用TM在儿科急性护理，但大多数研究都集中在重症监护或专科护理在办公室设置。我们在CR-VPED方面的经验表明，为新墨西哥州服务不足的农村急诊科患者提供一般儿科急诊护理是可行的。需要TM咨询的患者在年龄和临床表现上各不相同。
Objectives Pediatric patients living in rural, underserved areas have reduced access to medical care. There is a lack of research describing the use of telemedicine (TM) for general pediatric emergency medicine (PEM). In 2013, we established the Child Ready Virtual Pediatric Emergency Department Telehealth Network (CR-VPED), a PEM TM consultation service serving rural hospitals across the state of New Mexico. The aim of this article is to describe our experience for 6 years (2013-2018).Methods We describe the process of establishing the CR-VPED Telehealth Network. We reviewed all the TM consultations completed from June 22, 2013, to September 6, 2018. In our review, we focus on patient demographics, medical complaint, transfer status, type of referring provider, and problems encountered with each TM consultation.Results We had a total of 58 PEM TM consultations between June 22, 2013, and September 6, 2018. All consultations occurred at 6 of the 12 established sites. Most TM consultations (71%; 41/58) were with Indian Health Service sites. Among all TM consultations, patients ranged in age from 30 days to 17 years (mean, 54 months; median, 32 months). Only 26% (15/58) of the patients with TM consultations were transferred to the tertiary care hospital. There was a heterogeneous mix of chief complaints and diagnoses. Rash was the most common chief complaint (24%; 14/58). There was a mix of referring providers, with family medicine physicians being most common (31%; 18/58). Common technical issues were not properly recording the encounter into the electronic medical record (12%; 7/58) and difficulty logging into the CR-VPED Telehealth Network (9%; 5/58).Conclusions Previous studies have investigated the use of TM in pediatric acute care, but most studies have focused on critical care or subspecialty care in the office setting. Our experience with CR-VPED has shown that it has been feasible to provide general pediatric emergency care to patients in underserved, rural emergency departments across New Mexico. Patients requiring TM consultation were heterogeneous in age and presentation.