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Pediatric Neurology Telemedicine may Lead to Fewer Hospital Visits

Posted Monday, September 9, 2019 by Carl-Erich Kruse

While rural hospitals find it increasingly difficult to find and keep medical providers, there exists some hope for communities in the telemedicine model. Telemedicine refers to medicine practiced remotely, often through video conferencing technology.

It is widely acknowledged that community hospitals commonly lack the patient population necessary to maintain a staff of specialists. This requires patients to travel long distances to seek specialized care, or, even to go without.

In pediatric neurology at least, telemedicine appears to provide a viable model of care. A recent study from the Journal of the American Medical Association found that hospital visits were lower for patients who received neurology telemedicine care than in-person neurology care.

The study targeted patients under the age of 18 receiving care from University of California Davis Children’s Hospital (UCDCH) pediatric neurology telemedicine services against patients with registered home addresses in the UCDCH’s 33-county service area. From 2009 to 2018, 378 patients received telemedicine care compared to 3,791 patients that received in-person care. Neurologic telemedicine is long distance care provided by a neurologist who has access to imaging, charts, and video conferencing with the patient.

The study compared the hospital encounters following these telemedicine or in person medical visits. The researchers found that forty-nine of the telemedicine patients (7.9%) then had neurological hospital encounters; 473 in-person patients (12.5%) had neurological hospital encounters. The difference was even more striking when the researchers compared “all cause” hospital encounters. There, 10.6% of telemedicine patients and 27% of in-person patients had subsequent “all cause” hospital encounters.

A previous JAMA study also found that telemedicine appointments are more likely to be completed (not canceled or no-showed) than in-person visits.

The researchers acknowledged that the study had its limitations, especially regarding the fact that the patients were not randomized; also, they lacked access to the patients’ complete medical charts. These patients may have received care outside the UCDCH study area. Nevertheless, the fact remains that the researchers found lower rates of hospital encounters among children receiving telemedicine neurological care than children receiving in-person care.

What does this mean for you and me? As telemedicine programs get rolled into rural communities, we hope that the quality of care will improve in compatible specialties for these underserved populations. Interventional treatment may still be many miles away, literally, but improving the quality of preventative care will provide broad benefits to these populations.

Read the study here: Hospital Utilization Among Rural Children Served by Pediatric Neurology Telemedicine Clinics

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