Home-Based Telemedicine for Children with Medical Complexity
| Autor: | Elise Madeck Gentile, Matthew Amidon, Cheryl A. Lefaiver, Kathleen Webster, Denise B. Angst, Patricia M. Notario |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Telemedicine Adolescent pediatrics 020205 medical informatics Original telehealth Population Health Informatics 02 engineering and technology Telehealth Health Information Management Health care 0202 electrical engineering electronic engineering information engineering Humans Medicine Child education education.field_of_study business.industry Infant Multimorbidity General Medicine medicine.disease Home Care Services Home based Caregivers Socioeconomic Factors Patient Satisfaction Child Preschool home health monitoring Remote Sensing Technology Quality of Life Female Medical emergency business |
| Zdroj: | Telemedicine Journal and e-Health |
| ISSN: | 1556-3669 1530-5627 |
| DOI: | 10.1089/tmj.2018.0186 |
| Popis: | Background: Children with medical complexity (CMC) are high utilizers of health care services. Telehealth encounters may provide a means to improve care outcomes for this population. Objective: To evaluate the feasibility, usability, and impact of an in-home telehealth device in the care of CMC. Methods: This single-center feasibility study employed a nonblinded randomized clinical trial design. English-speaking caregivers of children within a pediatric complex care program with home Wi-Fi were eligible for participation. Participants were randomized 1.5:1 with stratification based on tracheostomy status to a control group that received usual care or an intervention group that received a telehealth device for in-home use. Patients were followed up for 4 months. The primary outcome was successful device connectivity and data transmission. Data included clinician encounter device usability; caregiver satisfaction; and encounter type, purpose, and cost. Descriptive statistics, negative binomial regression, and Kaplan–Meier plot were used for analysis. Results: Twenty-four patients were enrolled (9 controls, 15 in the intervention group) in September 2016. The telehealth device was attempted in 73 encounters. Device connectivity was successful 96% of the time. Image and sound quality were acceptable in 98% of visits. Caregivers expressed their overall satisfaction with the device. The hospitalization rate was lower in the intervention group (0.77 vs. 1.14 intensive care unit days/patient-months), resulting in $9,425/USD per patient savings compared with the control group. Conclusion: Despite small sample size and short observation period, this study demonstrated that use of an in-home telehealth device is feasible, well received by caregivers, and can result in decreased hospitalizations when compared with usual care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|