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Author: Hsuan-Hui Yang
Publisher:
ISBN: 9781321213355
Category :
Languages : en
Pages :
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Book Description
Telemedicine is defined as the exchange of medical information from one site to another using electronic communication to improve patient's health status. The applications of telemedicine include many models of care, but are frequently used in the inpatient setting, the outpatient setting, emergency departments, and home health. Novel telehealth program specific to the University of California Davis Children's Hospital (UC Davis Children's Hospital) include the use of telemedicine to connect hospitalized patients and their family and friends, and delivery of specialty consultations in emergency departments. However, there are limited data and studies that examine the impact of telemedicine in these settings, specifically how telemedicine can impact the pediatric hospitalized patient's experience, health outcomes for children seen in emergency departments, and economic outcomes of telemedicine when used to provide consultations to the emergency departments. Therefore, we evaluated the impact of telemedicine on these clinical and economic outcomes with various perspectives and analyses. First, we evaluated the impact of telemedicine on the reduction in stress experienced by hospitalized children in an urban hospital setting. University of California Davis Children's Hospital has established the Family-Link program, a videoconferencing program, to allow hospitalized children and their parents to virtually visit family members and friends using laptops, webcams, and a secure Wi-Fi connection. In this prospective cohort study of 367 hospitalized children who participated in the stress reduction study at the Children's Hospital between 2011 and 2013, 232 children participated in the Family-Link program and 135 did not participate. We examined the association of patient age, gender, length of hospitalization, and distance from children's home to the hospital with the children's level of stress through a propensity score matching model. We found that the use of Family-Link was significantly associated with a greater reduction in overall mean stress during hospitalization compared to non Family-Link users. We found this association particularly among the cohort of patients who lived closer to the hospital and had shorter lengths of hospitalization. In this cohort, the reduction in overall mean stress was 37% greater among Family-Link users than non Family-Link users. Second, we evaluated the impact of telemedicine consultations that are provided to acutely ill and injured children presenting to rural emergency departments (ED). We examined the association between patients receiving telemedicine on the appropriateness of hospital admission. In this retrospective cohort study of 138 acutely ill and injured children who presented to the rural EDs between 2003 and 2012, 74 children received telemedicine pediatric critical care consultations and 64 children received telephone pediatric critical care consultations. We further calculated and compared the overall and stratified (low and high risk for admission) observed to expected hospital admission ratios (O/E admission ratios) between the telemedicine and telephone cohorts by calculating the risk of admission using the Pediatric Risk of Admission (PRISA II) and the Revised Pediatric Emergency Assessment Tool (RePEAT). We found that the telemedicine cohort experienced a trend towards lower and more favorable overall O/E admission ratios compared to the telephone cohort. Telemedicine consultations resulted in more appropriate hospital admissions by 8.4% using PRISA II and 2.4% using RePEAT. We also found a higher rate of appropriate admissions when we stratified the patient populations into low and high risk of admission cohorts. Telemedicine consultations again resulted in more appropriate hospital admission for both PRISA II (low risk: 23.9%; high risk: 9.3%) and RePEAT (low risk: 14.7%; high risk: 19.9%) Lastly, we conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of the telemedicine program that provides consultations to acutely ill and injured children presenting to rural EDs. We conducted these analyses comparing the telemedicine model of care to telephone consultations, the current standard of care, from a health care system perspective. We found that the average cost for a telemedicine consultation was $3,238 per child/ED/year in 2009 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared to telephone consultations, resulting in a cost reduction of $4,146 per child/ED/year. Our probabilistic CEA demonstrated that telemedicine consultations were less costly than telephone consultations in 53% of simulation iterations. The ROI was calculated to be 1.28 ($4,146/$3,238) from the base-case analysis and estimated to be 1.46 from the probabilistic analysis, suggesting a $1.46 return for each dollar invested in telemedicine. Treating ten acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $41,460 per ED. In conclusion, the findings from these studies significantly contribute to current knowledge of pediatric telemedicine in both urban and rural hospital settings. The results demonstrate that the use of telemedicine in pediatric care not only help improve pediatric patients' quality of care, but also help reduce disparities in access to specialist physicians for acutely ill and injured children in rural areas. Moreover, our study findings in economic evaluation have important implications for clinicians, health administrators, and policy makers considering implementing similar telemedicine care models for children living in rural communities.
Author: Hsuan-Hui Yang
Publisher:
ISBN: 9781321213355
Category :
Languages : en
Pages :
Get Book Here
Book Description
Telemedicine is defined as the exchange of medical information from one site to another using electronic communication to improve patient's health status. The applications of telemedicine include many models of care, but are frequently used in the inpatient setting, the outpatient setting, emergency departments, and home health. Novel telehealth program specific to the University of California Davis Children's Hospital (UC Davis Children's Hospital) include the use of telemedicine to connect hospitalized patients and their family and friends, and delivery of specialty consultations in emergency departments. However, there are limited data and studies that examine the impact of telemedicine in these settings, specifically how telemedicine can impact the pediatric hospitalized patient's experience, health outcomes for children seen in emergency departments, and economic outcomes of telemedicine when used to provide consultations to the emergency departments. Therefore, we evaluated the impact of telemedicine on these clinical and economic outcomes with various perspectives and analyses. First, we evaluated the impact of telemedicine on the reduction in stress experienced by hospitalized children in an urban hospital setting. University of California Davis Children's Hospital has established the Family-Link program, a videoconferencing program, to allow hospitalized children and their parents to virtually visit family members and friends using laptops, webcams, and a secure Wi-Fi connection. In this prospective cohort study of 367 hospitalized children who participated in the stress reduction study at the Children's Hospital between 2011 and 2013, 232 children participated in the Family-Link program and 135 did not participate. We examined the association of patient age, gender, length of hospitalization, and distance from children's home to the hospital with the children's level of stress through a propensity score matching model. We found that the use of Family-Link was significantly associated with a greater reduction in overall mean stress during hospitalization compared to non Family-Link users. We found this association particularly among the cohort of patients who lived closer to the hospital and had shorter lengths of hospitalization. In this cohort, the reduction in overall mean stress was 37% greater among Family-Link users than non Family-Link users. Second, we evaluated the impact of telemedicine consultations that are provided to acutely ill and injured children presenting to rural emergency departments (ED). We examined the association between patients receiving telemedicine on the appropriateness of hospital admission. In this retrospective cohort study of 138 acutely ill and injured children who presented to the rural EDs between 2003 and 2012, 74 children received telemedicine pediatric critical care consultations and 64 children received telephone pediatric critical care consultations. We further calculated and compared the overall and stratified (low and high risk for admission) observed to expected hospital admission ratios (O/E admission ratios) between the telemedicine and telephone cohorts by calculating the risk of admission using the Pediatric Risk of Admission (PRISA II) and the Revised Pediatric Emergency Assessment Tool (RePEAT). We found that the telemedicine cohort experienced a trend towards lower and more favorable overall O/E admission ratios compared to the telephone cohort. Telemedicine consultations resulted in more appropriate hospital admissions by 8.4% using PRISA II and 2.4% using RePEAT. We also found a higher rate of appropriate admissions when we stratified the patient populations into low and high risk of admission cohorts. Telemedicine consultations again resulted in more appropriate hospital admission for both PRISA II (low risk: 23.9%; high risk: 9.3%) and RePEAT (low risk: 14.7%; high risk: 19.9%) Lastly, we conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of the telemedicine program that provides consultations to acutely ill and injured children presenting to rural EDs. We conducted these analyses comparing the telemedicine model of care to telephone consultations, the current standard of care, from a health care system perspective. We found that the average cost for a telemedicine consultation was $3,238 per child/ED/year in 2009 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared to telephone consultations, resulting in a cost reduction of $4,146 per child/ED/year. Our probabilistic CEA demonstrated that telemedicine consultations were less costly than telephone consultations in 53% of simulation iterations. The ROI was calculated to be 1.28 ($4,146/$3,238) from the base-case analysis and estimated to be 1.46 from the probabilistic analysis, suggesting a $1.46 return for each dollar invested in telemedicine. Treating ten acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $41,460 per ED. In conclusion, the findings from these studies significantly contribute to current knowledge of pediatric telemedicine in both urban and rural hospital settings. The results demonstrate that the use of telemedicine in pediatric care not only help improve pediatric patients' quality of care, but also help reduce disparities in access to specialist physicians for acutely ill and injured children in rural areas. Moreover, our study findings in economic evaluation have important implications for clinicians, health administrators, and policy makers considering implementing similar telemedicine care models for children living in rural communities.
Author: C.Jason Wang
Publisher: Elsevier Health Sciences
ISBN: 0323710883
Category : Medical
Languages : en
Pages : 240
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Book Description
In collaboration with Consulting Editor Dr. Bonita Stanton, the Guest Editors of this issue of Pediatric Clinics of North America have comprehensively review the current and future opportunities for implementing telehealth into pediatric practice. Expert authors have written review articles that provide information based on current knowledge of implementation of technologies but also ask questions about how to implement and what potential challenges there will be. Articles are specifically devoted to: Overview of Telehealth for Pediatricians; Role of Doctor—Patient Relationship in Telehealth; Design Purpose and Design Thinking for Telehealth; How to Implement Telehealth in Pediatrics; Issues Related to Adoption of Health Apps and Telemedicine Programs; Workforce Trends and Business Model for Telehealth; Moral, Political and Economic and Social Dilemmas of Telehealth; Automated Digital Health with Big Data, Predictive Analytics and AI; Tele-rounds and Cased-Based Training; Role of Text-messaging and Messaging apps in telehealth; High-Quality Telehealth Training Programs; Technical and Regulatory Issues of Telehealth Medicine; and Global Health Perspective on Telehealth. Pediatricians will come away with the information they need to employ telemedicine in their clinical practice
Author: C. Almazán
Publisher:
ISBN:
Category :
Languages : en
Pages : 69
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Book Description
This document is part of the European Project Technology Assessment in Teleneuromedicine (TASTE). The contents of this report is structured in two distinctive parts, namely Clinical Benefit and Economic Evaluation of Telemedicine. Each part covers an extensive literature review of telematic applications in neurosciences and discusses the main topics for the development of an assessment method in subsequent phases in the project. The search of three biomedical databases revealed a paucity of information. Of the 335 papers found to be of some relevance, only 32 met the specific eligibility criteria of a clinical study with 10 or more patients dealing with some measure of process or outcome of care. Although, only 5 studies fulfilled the inclusion criteria, the literature search found other important contributions to the study of economic aspects of Telemedicine. For many reasons traditional methods for economic evaluation are difficult to apply to Telemedicine.
Author: Wendy Ungar
Publisher: OUP Oxford
ISBN: 9780199547494
Category : Medical
Languages : en
Pages : 0
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Book Description
Guidelines for conducting health economic evaluations have become increasingly standardized, however they don't address the unique concerns of the paediatric population. This is the first textbook to address economic evaluation in child health.
Author: Betty Ferrell
Publisher:
ISBN: 0190244186
Category : Family & Relationships
Languages : en
Pages : 161
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Book Description
Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309262011
Category : Medical
Languages : en
Pages : 159
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Book Description
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
Author: Karen Schulder Rheuban
Publisher: McGraw Hill Professional
ISBN: 1259837416
Category : Medical
Languages : en
Pages : 337
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Book Description
The first complete guide to the rapidly expanding field of telehealth From email to videoconferencing, telehealth puts real-time healthcare solutions at patients’ and clinicians’ fingertips. Every year, the field continues to evolve, enhancing access to healthcare, supporting clinicians, and improving the patient experience. However, since telehealth is in its infancy, no text has offered a comprehensive, definitive survey of this up-and-coming field—until now. Written by past presidents of the American Telemedicine Association, Understanding Telehealth explains how clinical applications leveraging telehealth technology are optimizing healthcare delivery. In addition, this timely resource examines the bedrock principles of telehealth and highlights the safety standards involved in the diagnosis and treatment of patients through digital communications. Logically organized and supported by high-yield clinical vignettes, the book begins with essential background information, including a look at telehealth history, definitions and roles, and rural health. It then provides an overview of clinical services for adults, from telestroke to telepsychiatry. The third section addresses pediatric clinical services, encompassing pediatric emergency and critical care, telecardiology, and more. A groundbreaking resource: •Chapters cover a broad spectrum of technologies, evidence-based guidelines, and application of telehealth across the healthcare continuum •Ideal for medical staff, public healthcare executives, hospitals, clinics, payors, healthcare advocates, and researchers alike •Incisive coverage of the legal and regulatory environment underpinning telehealth practice
Author: Colin Robson
Publisher: SAGE
ISBN: 1526417901
Category : Social Science
Languages : en
Pages : 262
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Book Description
Evaluation research can assess the value and effectiveness of interventions and innovations involving people. While this has often been on a grand scale, this book focuses on small-scale projects carried out by an individual or small group, typically lasting for weeks or at most a few months, at a local rather than national level. Using limited jargon and featuring integrated, real-world examples, this second edition offers a clear, accessible background to evaluation and prepares you to undertake your own small-scale evaluation research project. Key features include discussion of: Different approaches to evaluation and how to choose between them The advantages and disadvantages of randomized controlled trials (RCTs) Realist evaluation and its increasing importance The centrality of ethical and political issues The influence and opportunity of the Internet Tightly focused on the realities of carrying out small-scale evaluation, Small-Scale Evaluation is a highly practical guide covering the needs of both social scientists and others without this background. Colin Robson is an Emeritus Professor in the School of Human & Health Sciences at the University of Huddersfield.
Author: H. Peter Soyer
Publisher: Springer Science & Business Media
ISBN: 3642208010
Category : Medical
Languages : en
Pages : 192
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Book Description
Written by leading teledermatologists and telemedicine experts, this hands-on guide addresses the practical needs of the many emerging teledermatology services worldwide. It covers the medical and technical prerequisites for such services as well as the photographic imaging essentials. It also illustrates the performance of teledermatology by means of clinical examples, discusses teledermatology in underdeveloped countries, and presents specialized methods of teledermatology. The impact of telemedicine on the doctor-patient relationship is explored, and the advantages that accrue from improving access to expert knowledge are explained. In addition, quality assurance, legal assumptions, economic aspects, and the future horizons of such health care services are all considered. A comprehensive appendix provides information on training opportunities, sample protocols, consent forms, information sheets, references, and relevant web links.
Author: Gulla, Vincenzo
Publisher: IGI Global
ISBN: 1466629800
Category : Medical
Languages : en
Pages : 428
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Book Description
Innovations in providing vital health care in homes and remote areas could ultimately change the way society views the health care markets and services in the future. Telehealth systems promise innovations that can extend a hospitals knowledge and resources, connecting with patients who may not be able to otherwise receive services. Telehealth Network for Hospital Services: New Methodologies carefully focuses on and describes different networks that link hospitals and their services to patients outside their territory. This reference work not only focuses on the technology that is integral to the function of a telehealth network, but also its users, and the collaboration that is necessary to be successful. Researchers, practitioners, and health professionals interested in understanding health markets and organizations, as well as the innovative technologies that help them function, will greatly benefit from this publication.