Have you ever spent the better part of a morning or afternoon taking your child to the doctor for a routine complaint and come home exhausted?
It’s not easy, particularly if you have other children who are too young to stay home alone. You’ll either need a babysitter, or you’ll have to take them with you to the pediatrician’s office and possibly expose them to something contagious.
Telemedicine makes sense for a number of childhood health issues. Sometimes we’re not sure what a rash is, or whether her eye is red from conjunctivitis or from her rubbing it due to allergies. More pediatricians and pediatric specialists are incorporating telemedicine services, making things easier and more convenient for parents, children, and themselves. In fact, telemedicine could revolutionize how many childhood health conditions are handled.
Telemedicine and Childhood Obesity
Childhood obesity is a problem because it predisposes children to numerous health problems once they reach adulthood. In some states, more than 20% of children are considered obese, and doctors and parents are having to develop ways to help children eat healthier and participate in more physical activities to improve their health.
The University of Michigan’s CS Mott Children’s Hospital recently launched a telemedicine program designed to combat childhood obesity. The hospital partnered with digital wellness and telemedicine platform Fruit Street to create a program for pediatric patients that combines monitoring data from wearable devices (like FitBit, Jawbone UP, and the AppleWatch) with telemedicine visits. Physicians, psychologists, dietitians, and exercise physiologists will participate in a Virtual Lifestyle Medicine Clinic to help young people develop better habits and manage their weight.
Cerebral Palsy and Telemedicine in Australia
A retrospective study in Queensland, Australia found that telemedicine had a positive impact on pediatric patients with orthopaedic problems, particularly for patients with cerebral palsy. The goal was to determine ways telemedicine could be used to address healthcare access in rural areas. Researchers found that children with known disabilities comprised a large percentage of those using telemedicine.
They believe that the costs and difficulties of transporting children with cerebral palsy were key factors in a preference for telemedicine in non-emergency situations. Telemedicine appeared to be sufficient for meeting needs of many patients. Of the 126 patients studied, 28 were ultimately referred for a consultation and eventually surgery, while 23 had follow-up by telemedicine. The study indicates telemedicine is economical and practical while remaining effective.
Telemedicine and Well Child Check-Ups
A company called CloudVisit is developing pediatric telemedicine services that incorporate home health devices, mobile apps, and video conference appointments so that pediatric practices can launch their own patient telemedicine programs. Pediatricians could, for example, offer patient families home devices like scales, height trackers, and thermometers to allow parents to easily monitor their child’s development and wellness. With a mobile app, parents can send health metrics directly to the pediatrician’s practice.
When a child needs to be seen by a doctor, in some cases secure video appointments can allow children to be seen without leaving home. CloudVisit expects its services to be used for situations like non-urgent illnesses, newborn guidance and breastfeeding support, and for dealing with illness when families are away from home on vacation.
Store and Forward Telemedicine for Underserved Children
The Florida Association of Free and Charitable Clinics recently awarded a $105,000 grant to the University of Miami Pediatric Mobile Clinic that will partially be used to expand the clinic’s telemedicine services. Specifically, the clinic plans to increase store and forward telemedicine to make it easier to coordinate care by specialists.
For example, if a child needs a dermatology consultation, the clinic can take a picture of the rash or skin problem and upload it securely for a dermatologist to later look at and evaluate for diagnosis. The Pediatric Mobile Clinic hopes that expansion of its telemedicine capabilities will be especially valuable for children whose insurance, financial, and transportation limitations prevent them from seeing specialists.
Barriers to More Widespread Telemedicine for Children
Telemedicine is expanding, but there are still barriers that prevent it from reaching its full potential. A November 2014 study of 25 providers with current, former, or planned pediatric emergency telemedicine programs identified five barriers to success:
- Difficulty in credentialing across hospitals
- Integration of telemedicine into established workflows
- Usability of technology
- Lack of physician support
- Misaligned incentives that don’t reward hospitals for using telemedicine
But despite problems with credentialing and reimbursement, studies have found that care quality for pediatric patients in rural emergency departments improved significantly when telemedicine consultations were incorporated.
The Medicare Access and CHiP Reauthorization Act
The Medicare Access and CHiP Reauthorization Act was passed by Congress on April 15, 2015 and signed by President Obama on April 16. This bill introduced changes to reimbursement methodologies, which are expected to better align reimbursement for healthcare services with the access, quality, and convenience that telemedicine services provide. With passage of this law, healthcare providers have more reason to innovate care delivery with services including telemedicine that will position them to make better use of evolving payment models.
Under the new law, the General Accounting Office will conduct a study of telemedicine and Medicare for publication by April 2017. Many provisions in the new law are intended to promote innovation in care delivery with technologies like telemedicine, to keep quality of care high while keeping costs contained and increasing convenience.
Telemedicine law is finally starting to catch up to telemedicine technology, and this is expected to be great news for children and their families. Children have different healthcare needs than adults, but telemedicine offers families and physicians new, more convenient options for delivery of care, and these options should help keep costs contained as well. With telemedicine, getting a child help for common ailments like earaches is less likely to involve the time, expense, and coordination involved in taking time off work and getting a babysitter for other children in the family.
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