Journal article
Paediatric tele-emergency care: A study of two delivery models
Journal of telemedicine and telecare, Vol.27(1), pp.23-31
01/2021
DOI: 10.1177/1357633X19839610
PMID: 30966860
Abstract
Introduction
Tele-emergency models have been utilized for decades, with growing evidence of their effectiveness. Due to the variety of tele-emergency department (tele-ED) models used in practice, however, it is challenging to build standardized metrics for ongoing evaluation. This study describes two tele-ED programs, one specialized and one general, that provide care to paediatric populations. Through an examination of model structures and patient populations, we gain insight into how evaluative measures should reflect tele-ED model design and purpose.
Methods
Qualitative descriptions of the two tele-ED models are presented. We show a retrospective cohort analysis describing paediatric patients’ key characteristics, reasons for visit, and disposition status by case/control status. Case/control patient encounter data were collected October 2015 through December 2017, from 15 spoke hospitals within each tele-ED program.
Results
The two tele-ED models serve distinct paediatric populations, and measures of tele-ED utilization and disposition reflect those differences. In the specialized University of California (UC) Davis Health program, tele-ED was utilized in 36% of paediatric critical care encounters and 78% of those were transferred. In the Avera eCARE program, tele-ED was activated in 1.7% of paediatric encounters and 50.6% of those were transferred. When Avera eCARE paediatric encounters were stratified by severity, measures of tele-ED use and disposition status among high-severity encounters were more similar to UC Davis Health.
Discussion
This study describes how design choices of tele-ED models have implications for evaluative measures. Measures of tele-ED model success need to reflect model purpose, populations served, and for whom tele-ED service use is appropriate.
Details
- Title: Subtitle
- Paediatric tele-emergency care: A study of two delivery models
- Creators
- Paula A Weigel - University of Iowa, Iowa City, IA, USAKimberly AS Merchant - University of Iowa, Iowa City, IA, USAAmy Wittrock - Avera eCARE, Sioux Falls, SD, USAJamie Kissee - University of California Davis, Davis, CA, USAFred Ullrich - University of Iowa, Iowa City, IA, USAAmanda L Bell - Avera Health, Sioux Falls, SD, USAJames P Marcin - University of California Davis, Davis, CA, USAMarcia M Ward - University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Journal of telemedicine and telecare, Vol.27(1), pp.23-31
- DOI
- 10.1177/1357633X19839610
- PMID
- 30966860
- NLM abbreviation
- J Telemed Telecare
- ISSN
- 1357-633X
- eISSN
- 1758-1109
- Publisher
- SAGE Publications
- Language
- English
- Date published
- 01/2021
- Academic Unit
- Rural Telehealth Research Center; Health Management and Policy
- Record Identifier
- 9984221637902771
Metrics
4 Record Views