Telemedicine and Critical Care

Abstract

Critical Care| July 01 2004 Telemedicine and Critical Care AAP Grand Rounds (2004) 12 (1): 9–10. https://doi.org/10.1542/gr.12-1-9-a Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Telemedicine and Critical Care. AAP Grand Rounds July 2004; 12 (1): 9–10. https://doi.org/10.1542/gr.12-1-9-a Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: care of intensive care unit patient, telemedicine Source: Marcin JP, Nesbitt TS, Kallas HJ, et al. Use of telemedicine to provide pediatric critical care inpatient consultations to under served rural northern California. J Pediatr. 2004;144:375–380. To compare the outcome of care when an intensivist was present versus available by telemedicine consultation, investigators from the University of California, Davis (UCD) Children’s Hospital studied critically ill pediatric patients initially treated at Mercy Medical Center (MMC) in Redding, Calif, during 2 periods. This rural hospital is 160 miles north of Sacramento, where the closest California Children’s Service-certified pediatric intensive care unit (PICU) to Redding is located. During October 1997-September 1998, MMC employed a solo pediatric intensivist to care for children in its adult ICU, and during April 2000-April 2002, the medical center had a telemedicine connection to the UCD PICU. The telemedicine connection was made available for consultation to fill the void in rural ICU treatment of children. Less critically ill patients received care in Redding, while the more gravely ill children were stabilized with support available from the UCD PICU staff and transported to tertiary care. The authors adjusted for severity of patient illness using the Pediatric Risk of Mortality, version III (PRISM III) score.1 They surveyed care providers, parents, and nurses at MMC regarding the quality of care given to patients who received a telemedicine consultation, including the importance of remaining in their local community and their willingness to participate in telemedicine consultations in the future. Children who received a telemedicine consultation (n=47) had a higher PRISM III score (mean 9.6) when compared to the earlier study period with a solo intensivist (n=116, mean 7.5) and to children who did not need a consultation (mean 7.7). All patient groups had lower than predicted mortality based on PRISM III scores. Parents and care providers rated their satisfaction using a Likert Scale. Local physicians rated the audiovisual quality, ease of equipment use, and their ability to understand the consultation from “very satisfied to extremely satisfied.” Nurses rated ease of equipment use lower than physicians. Parents and nurses rated the importance of receiving care locally as significantly more important than physicians. All groups rated the overall quality of the telemedicine consultation as very to extremely satisfactory. The authors conclude that telemedicine could successfully provide supportive care for select critically ill children in a rural setting with lower than predicted mortality. Some states, including California, have established standards for PICUs that are difficult for rural hospitals to meet without large financial losses. By necessity, children in rural communities who require ICU care are commonly transferred long distances from their homes to be treated in a regional PICU. The authors show that selective use of telemedicine consultation (available 24 hours a day, 7 days a week) enabled many children who were less critically ill to receive safe care in a rural hospital adult ICU. However, telemedicine requires 24-hour technical support and many programs are only possible because of short-term grant funding. The authors used a T1 data... You do not currently have access to this content.