A Comparison of Teleburn to In-Person Consultation of Pediatric Patients in a Children's Emergency Department.

Abstract

Pediatric burn care is an essential component to emergency care and there are disparities in access to regional burn centers. Teleburn is a tool that enables providers without a certified burn center to provide photos of a burn to experts and receive recommendations. The purpose of this study is to evaluate the effectiveness of a Teleburn system to the in-person consultation regarding burn infection rate, clinic follow up rate, post-burn admission rate, and 72-hour bounce back rate. Data was collected from December 2019-March 2022 through the electronic medical record. A total of 416 patient encounters that met criteria were analyzed. A non-inferiority study was designed comparing proportional outcomes of Teleburn initial visits to emergency department visits regarding burn infection rate, clinic follow up rate, post-burn admission rate, and 72-hour bounce back rate. The data were compared with a difference of greater than 10% being considered inferior. No differences were identified in rates of readmission - 1.67% difference (95% CI -27%< x< 23.8%) and return within 72 hours - 0.7% difference (-18.4%< x< 19.7%). Teleburn patients were 12.6% less likely to follow up (2.7%< x< 22.40%). Only one infection was identified, which was insufficient to conclude non-inferiority. While convenient, Teleburn consult could not be demonstrated to be non-inferior to in-person consultation. No differences in infection rates were identified, and difference in readmission and return were clinically insignificant. This study demonstrates that Teleburn may be effective and feasible to regional burn centers if follow up can be improved.