Telemedicine consultations with pediatric specialists can improve the quality of care and reduce the number of drug errors in rural settings, according to a study from UC Davis Medical Center.
Rural physicians face distinct disadvantages when providing critical care for severely ill or injured pediatric patients, the study notes. In addition to lacking pediatric specialty training and experience treating children, emergency physicians in small rural hospitals often lack access to EMRs, computerized order entry and 24-hour pharmacist coverage. Previous studies have confirmed that children are at greater risk when treated in rural emergency rooms.
The study looked at the care provided to 234 patients in eight rural hospitals. In 73 cases, or 31 percent, a pediatric critical care specialist conferred, over a secure connection, with an emergency physician, the patient, a nurse and a parent or guardian (when available). In 85 cases, or 36 percent, the specialty consultations were conducted by telephone. In 76 cases, or 32 percent, the emergency department team received no specialist consult.
The error rate for the telemedicine group was 3.4 percent compared to 10.8 percent for telephone consultations and 12.5 percent when there were no consults. The most common errors were incorrect doses; drug doses for children are based on weight. Telemedicine patients had far fewer dosage errors.
In particular, the contrast between the telemedicine and telephone error rates seems to indicate that visual interaction is a key component to improving care.
The eight rural hospitals were provided telemedicine services, high-resolution monitors and secure power supplies to facilitate the consultations. In addition, UC Davis made pediatric critical care specialists available around-the-clock to provide these consults.
To determine the error rates, researchers looked at charts from the eight hospitals. Patients up to 17 years old were chosen based on their high level of illness or injury. Emergency department physicians made their own decisions on whether to take advantage of the telemedicine tools.
These findings could have a significant impact on care for all patients. According to the Institute of Medicine, hospital medical errors cause 98,000 preventable deaths each year.
Source: UC Davis Medical Center , November 25, 2013
Telemedicine Technologies: Information Technologies in Medicine and Telehealth focuses on how medical information can be reliably transmitted through wireless communication networks. It explains how they can be optimized to carry medical information in various situations by utilizing readily available traditional wireless local area network (WLAN) and broadband wireless access (BWA) systems.