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Telemedicine Found to Improve Rural Pediatric Emergency Care

James Marcin

James Marcin (University of California, Davis)

A study of rural emergency room cases in northern California shows physician consultations with teleconferencing result in higher quality of  care for seriously ill and injured children. The findings of pediatrician James Marcin and colleagues at University of California in Davis were published yesterday online in the journal Critical Care Medicine (paid subscription required).

Telemedicine uses telecommunications technologies, such as video conferencing, as part of long-distance clinical health care. The use of telemedicine is increasing to provide access to specialists in rural or under-served populations, as well as for emergency care, particularly in cases of stroke. Few studies, however, document the impact of consultations through telemedicine, compared to voice-telephone consultations or no remote consultations.

Marcin and colleagues from UC-Davis and University of Utah reviewed medical records of 320 seriously ill or injured children, age 17 and under,  at five rural Northern California emergency departments between 2003 and 2007. The emergency rooms at had videoconferencing equipment for remote consultations. Of those 320 cases, 58 received remote consultations through telemedicine, 63 cases had telephone consultations, and 199 had no specialist consultations.

The Davis team evaluated for all of the patients their quality of care, accuracy of the diagnosis and course of treatment, and parents’ satisfaction with their children’s care. Two independent emergency-medicine physicians measured quality of care with a seven-point rating scale during reviews of the patients’ medical records.

The results show cases with telemedicine consultations receive higher quality-of-care scores than either cases where consultations were conducted by telephone or where no consultation occurred. In addition, on-site emergency physicians were more likely to change their diagnosis or treatment plans as a result of telemedicine consultations rather than telephone calls. Parents likewise were more satisfied with the care given their children and believed they received a higher  quality of care when telemedicine was used, compared to telephone calls.

Marcin started the pediatric critical-care telemedicine program at UC-Davis that so far provided more than 5,500 telemedicine consultations with rural California hospitals.

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