Journal article
Caring for Children with Asthma through Teleconsultation: "ECHO-Pac, The Electronic Children's Hospital of the Pacific"
Telemedicine journal and e-health, Vol.10(2), pp.138-146
06/01/2004
DOI: 10.1089/tmj.2004.10.138
PMID: 15319043
Abstract
A Web-based store-and-forward teleconsultation asthma management system was implemented
to provide subspecialty asthma care to military children with asthma living in the
Western Pacific. Seven children with moderate to severe asthma (mean age 11.9 ± 3.7 years)
were followed for 1 year by their primary care provider (PCM) using a Web-based asthma
pathway, with regular pediatric pulmonary teleconsults to Tripler Army Medical Center. Therapeutic
monitoring included MPEG video recording of patient using metered-dose inhaler
(MDI) technique submitted to the pulmonologist at specified intervals. Utilization of services
for unscheduled asthma-related visits was monitored. PCMs were surveyed regarding their
asthma practice before and after the intervention. Data were analyzed using Student's
t
test
for continuous variables and Wilcoxon signed-rank or chi-square for noncontinuous variables.
Therapeutic adherence was evidenced by improved inhaler technique in all patients. There
were fewer ED visits for asthma (3.85 ± 5.14, range 0-15 vs. 0 visits,
p
< 0.05) and fewer unscheduled
acute clinic visits (1.57 ± 1.27, range 0-4 vs. 0.286 ± 0.48,
p
< 0.05) in the study year
versus the preceding year. There were two hospitalizations in the year prior to the study; however,
no patients were hospitalized during the study PCM use of an asthma action plan increased
from 24% to 73% (
p
< 0.01) and provision of asthma education increased from 18% to
73%, (
p
< 0.01). However, PCMs reported that they were not more likely to watch their patient's
MDI technique themselves (29% vs. 45%) nor order or interpret spirometry on their
patients (12 vs. 18%). In this project, children with asthma followed by teleconsultation had
improved outcomes. Store-and-forward teleconsultation can be used to follow children with
chronic disease such as asthma over time.
Details
- Title: Subtitle
- Caring for Children with Asthma through Teleconsultation: "ECHO-Pac, The Electronic Children's Hospital of the Pacific"
- Creators
- Francis MaloneCharles W CallahanDebora S ChanScott SheetsDonald A Person
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.10(2), pp.138-146
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/tmj.2004.10.138
- PMID
- 15319043
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Language
- English
- Date published
- 06/01/2004
- Academic Unit
- Pulmonary Medicine; Stead Family Department of Pediatrics
- Record Identifier
- 9984093235802771
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