Faculty Collaboration Database

Home-Based Telemedicine for Children with Medical Complexity. Telemed J E Health 2019 Nov;25(11):1123-1132

Date

01/11/2019

Pubmed ID

30628860

Pubmed Central ID

PMC6842894

DOI

10.1089/tmj.2018.0186

Scopus ID

2-s2.0-85066097420 (requires institutional sign-in at Scopus site)   39 Citations

Abstract

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.

Author List

Notario PM, Gentile E, Amidon M, Angst D, Lefaiver C, Webster K

Author

Matthew D. Amidon DO Assistant Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Caregivers
Child
Child, Preschool
Female
Home Care Services
Humans
Infant
Male
Multimorbidity
Patient Satisfaction
Quality of Life
Remote Sensing Technology
Socioeconomic Factors
Telemedicine