A remote-healthcare model for children in daycare, elementary schools and neighborhood after-hours sites was effective in establishing diagnoses and ruling out more serious conditions, according to a study published at Telemedicine and e-Health.
The authors says these common diagnoses should be eligible for telemedicine reimbursement, and limiting reimbursement to these diagnoses would limit the value of this model relatively little.
Health-e-Access, a connected care model designed to serve children with acute illness, has been used in Rochester, New York, since 2001. The authors, from Case Western Reserve University and University of Rochester Medical Center, stress that the medical home is central to gaining and maintaining trust between the physician and a child's parents.
With videoconferencing as the preferred communication mode, but also offered by telephone, trained staff at the child's site conferred with the physician and parents about the health issue and collected still images, video clips and audio files that were sent through a secure server.
An all-purpose camera captured ear canal, tympanic membrane, nose, throat, eye and skin images. In addition, rapid streptococcal antigen tests, throat cultures and skin or scalp cultures for fungus or bacteria were available at the physician's request.
The primary diagnoses were found to be similar to those seen among children taken to emergency departments and those commonly seen in primary care settings--such as ear infections, strep throat and various viral infections.
Of the 13,812 Health-e-Access visits looked at, 98.2 percent were completed and 95.2 percent of primary diagnoses were supported. More serious conditions were ruled out in 95 percent of cases, according to the study.
The use of telemedicine outside of hospital walls for children is growing. For example, Children's Health hospital system in North Texas has served as a model for a new law in Texas that allows school-based telemedicine visits for children covered by Medicaid.
There is also a Southeast Minnesota Beacon Community project that allows parents, physicians and schools to work together to better manage children's asthma.
To learn more:
- here's the research