Use of Telehealth (TH) in a Pediatric Ambulatory Setting: A Patient Survey
CPS ePoster Library. Rajani H. Jun 1, 2017; 176646; 85
Dr. Hasu Rajani
Dr. Hasu Rajani
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Abstract
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Background:  Telemedicine (TM) has been defined as “the use of medical information exchanged from one site to another via electronic communications to improve a patient's clinical health status”.Telehealth (TH) refers to a broader scope of remote healthcare services than TM. TH can refer to remote non-clinical services, such as provider training, administrative meetings, in addition to clinical services.Telemedicine and Telehealth, as commonly used today, can be considered synonymous.Telecommunications has had a role in medical care since the civil war. The invention of the telephone and radio expanded medical telecommunications. The telephone maintains a central role in medical communications.Earliest recorded reference to TM involved teleradiology and distant transmission and interpretation of radiographic images.TH use has seen an exponential increase in it's use over the past decade. It has been successfully used in neonatology, critical care, for following chronic disease monitoring, outpatient care and education Advantages of TH●increased access to medically underserved, and remote locations●decreased cost to health care system and the patient's family●TH is used increasingly to provide specialty consultations●Coupling videoconferencing with peripheral devices (stethoscopes, diagnostic sets, ultrasound machines) enables simulation of in-person bedside consultationFor the past 10 years, our group has been using TH to provide pediatric consultation services to a number of smaller communities in rural Alberta. Anecdotal reports from patients indicated that there was satisfaction with this process however no formal survey was completed.  

Objectives: Primary: To gauge the satisfaction of TH-based pediatric outpatient consultation service from a technological and professional point of view.Secondary: Assess access and cost benefit to patients accrued from a TH encounter compared to a face-to-face encounterThe study was reviewed and approved by the Health Ethics Research Board and NACTRC with AHS. 

Methods: ●Caregivers were contacted by the central TH booking administrator to be booked for a TH session with one of the pediatricians at the NECHC●At the time of contact for scheduling an appointment, the caregiver would be provided with a study summary●Those who declined were excluded, and entry made in the study Excel database●Those who agreed to participate were asked their preferred distribution method●For those who preferred email survey, the email address was recorded in the study Excel database●If a hard copy via fax was requested, this was recorded in the study Excel database●The TH clinical request was then completed with appropriate direction to email or fax survey●The participants received a reminder call two weeks later and email re-sent if requested●The survey which took 5 to 10 minutes to complete indicated that it was voluntary and confidential●Email data was collected by Select Survey.●Fax data was sent to designated TH fax machine and results back-entered in Select Survey●Data pulled from Select Survey for analysis and reporting●Sample size and response rate calculated with study Excel database

Results:

Conclusion: ●High level of satisfaction related to a TH encounter●Majority were very satisfied with the audio visual quality●Very satisfied with the quality of the consultation●Convenient and cost saving for the patient●All would want a TH appointment again 

●TH facilitates and may expedite access to medical care
●TH can be easily incorporated into a physician's daily patient schedule, where such technology is available.
●Future studies to consider actual cost savings to the health care system

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