School-Based Tele-Physiatry Assistance for Rehabilitative and Therapeutic Services (STARS) for Children with Special Health Care Needs Living in Rural and Underserved Communities

为生活在农村和服务欠缺社区的有特殊医疗保健需求的儿童提供基于学校的远程康复和治疗服务 (STARS) 援助

• 批准号: 10224612
• 负责人: James P Marcin
• 金额: $ 38.55万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-30 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224612
• 关键词: Based; Tele; Physiatry; Assistance; Rehabilitative

Project Abstract Medical Therapy Units (MTUs) are multidisciplinary county clinics that provide comprehensive medical management to children with special health care needs for durable medical equipment, orthotics, and therapy services. Unfortunately for children living in rural and underserved communities, MTU specialty care is often difficult to access because the most qualified specialist physicians to lead these encounters (pediatric physiatrists), are regionalized at large urban centers. As a result, these children are left to receive care in one of three ways: first, some pediatric physiatrists travel long distances to provide care in the local community MTU; second, some county MTUs hire non-specialist providers to provide the care, despite the fact that these providers lack expertise in the care of children with special health care needs; and third, some families and children are left with no other option but to travel long distances to receive care at a regionalized, urban MTU. In order to address the travel burdens and barriers to care, as well as to increase the quality of care provided to these children, we will implement a model of care using telemedicine to deliver pediatric physiatrist medical direction to MTUs located in rural and underserved communities. The objective of this application is to prospectively compare outcomes from our telemedicine-based model of care to two cohorts: patients who receive in-person pediatric physiatrist medical direction (the “gold standard”) and patients who receive medical oversight from non-specialist community providers. First, we hypothesize that when pediatric physiatrists use telemedicine to provide medical direction, parents/guardians of children will be equally satisfied with care received compared to parents/guardians of children who receive in-person care by pediatric physiatrists, and more satisfied than parents/guardians of children who receive care by non-specialist community providers. Second, we hypothesize that when pediatric physiatrists use telemedicine to provide medical direction, children will have equal adherence to an evidence- based hip surveillance program compared to children who receive in-person care by pediatric physiatrists, and better adherence to the hip surveillance program than children who receive care by non-specialist community providers. Third, we hypothesize that when pediatric physiatrists use telemedicine to provide medical direction to children with special health care needs living in rural and underserved communities, there will be significant cost savings compared to when pediatric physiatrists have to travel to distant MTUs and to when care is provided by non-specialist community providers. Our work is significant because we expect that this model of care will result in improved access, increased levels of patient-centeredness, higher quality of care, and will simultaneously reduce overall costs of care. We also expect that this model will be scalable and will be used by similar programs treating children with special health care needs throughout the country. 1

项目摘要 医疗治疗单位 (MTU) 是多学科县诊所，提供全面的医疗服务 对有特殊医疗保健需求的儿童进行耐用医疗设备、矫形器和治疗的管理 服务。不幸的是，对于生活在农村和服务欠缺社区的儿童来说，MTU 专业护理通常是 很难接触到，因为最有资格的专科医生来领导这些遭遇（儿科 理疗师），在大城市中心进行区域化。结果，这些孩子只能在一个地方接受照顾 三种方式：首先，一些儿科理疗师长途跋涉到当地社区提供护理 最大传输单元；其次，一些县 MTU 雇用非专业提供者来提供护理，尽管事实上这些提供者 提供者缺乏照顾有特殊医疗保健需求的儿童的专业知识；第三，一些家庭和 孩子们别无选择，只能长途跋涉去区域化的城市 MTU 接受护理。 为了解决旅行负担和护理障碍，并提高护理质量 为这些儿童提供服务，我们将实施一种利用远程医疗为儿科理疗师提供护理的模式 向位于农村和服务欠缺社区的 MTU 提供医疗指导。该应用程序的目标是 前瞻性地比较我们基于远程医疗的护理模式对两个队列的结果： 接受儿科理疗师现场医疗指导（“黄金标准”）以及接受医疗的患者 非专业社区提供者的监督。 首先，我们假设当儿科理疗师使用远程医疗提供医疗指导时， 与孩子的父母/监护人相比，孩子的父母/监护人对所接受的照顾同样满意 接受儿科理疗师亲自护理的儿童，比父母/监护人更满意 由非专业社区提供者照顾的儿童。其次，我们假设当小儿 理疗师使用远程医疗来提供医疗指导，孩子们将平等地遵守证据- 与接受儿科理疗师亲自护理的儿童相比，基于髋关节监测计划的儿童，以及 比接受非专业社区护理的儿童更好地遵守髋关节监测计划 提供商。第三，我们假设当儿科理疗师使用远程医疗来提供医疗指导时 对于生活在农村和服务欠缺社区的有特殊医疗保健需求的儿童来说，将会有大量的 与儿科理疗师必须前往遥远的 MTU 以及接受护理时相比，可以节省成本 由非专业社区提供者提供。 我们的工作意义重大，因为我们期望这种护理模式将改善获得服务的机会， 提高以患者为中心的水平，提高护理质量，同时降低总体成本 关心。我们还预计该模型将具有可扩展性，并将被用于治疗患有此类疾病的儿童的类似项目中使用。 全国各地的特殊医疗保健需求。 1

项目成果

Emerging Telepresence Technologies in Hybrid Learning Environments

混合学习环境中的新兴远程呈现技术

• DOI: 10.1145/3491101.3503728
• 发表时间: 2022
• 期刊: ACM CHI Conference on Human Factors in Computing Systems (CHI ’22
• 作者: Elmimouni, Houda;Paulin Hansen, John Paulin;Herring, Susan;Marcin, James;Orduna, Marta;Perez, Pablo;Rae, Irene;Read, Janet;Rode, Jennifer;Sabanovic, Selma
• 通讯作者: Sabanovic, Selma