Home-Based Telemedicine for Children with Medical Complexity
Background: Children with medical complexity (CMC) are high utilizers of health care services. Telehealth encounters may provide a means to improve care outcomes for this population. Objective: To evaluate the feasibility, usability, and impact of an in-home telehealth device in the care of CMC. Met...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc., publishers
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842894/ https://www.ncbi.nlm.nih.gov/pubmed/30628860 http://dx.doi.org/10.1089/tmj.2018.0186 |
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author | Notario, Patricia M Gentile, Elise Amidon, Matthew Angst, Denise Lefaiver, Cheryl Webster, Kathleen |
author_facet | Notario, Patricia M Gentile, Elise Amidon, Matthew Angst, Denise Lefaiver, Cheryl Webster, Kathleen |
author_sort | Notario, Patricia M |
collection | PubMed |
description | Background: Children with medical complexity (CMC) are high utilizers of health care services. Telehealth encounters may provide a means to improve care outcomes for this population. Objective: To evaluate the feasibility, usability, and impact of an in-home telehealth device in the care of CMC. Methods: This single-center feasibility study employed a nonblinded randomized clinical trial design. English-speaking caregivers of children within a pediatric complex care program with home Wi-Fi were eligible for participation. Participants were randomized 1.5:1 with stratification based on tracheostomy status to a control group that received usual care or an intervention group that received a telehealth device for in-home use. Patients were followed up for 4 months. The primary outcome was successful device connectivity and data transmission. Data included clinician encounter device usability; caregiver satisfaction; and encounter type, purpose, and cost. Descriptive statistics, negative binomial regression, and Kaplan–Meier plot were used for analysis. Results: Twenty-four patients were enrolled (9 controls, 15 in the intervention group) in September 2016. The telehealth device was attempted in 73 encounters. Device connectivity was successful 96% of the time. Image and sound quality were acceptable in 98% of visits. Caregivers expressed their overall satisfaction with the device. The hospitalization rate was lower in the intervention group (0.77 vs. 1.14 intensive care unit days/patient-months), resulting in $9,425/USD per patient savings compared with the control group. Conclusion: Despite small sample size and short observation period, this study demonstrated that use of an in-home telehealth device is feasible, well received by caregivers, and can result in decreased hospitalizations when compared with usual care. |
format | Online Article Text |
id | pubmed-6842894 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Mary Ann Liebert, Inc., publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-68428942019-11-12 Home-Based Telemedicine for Children with Medical Complexity Notario, Patricia M Gentile, Elise Amidon, Matthew Angst, Denise Lefaiver, Cheryl Webster, Kathleen Telemed J E Health Original Background: Children with medical complexity (CMC) are high utilizers of health care services. Telehealth encounters may provide a means to improve care outcomes for this population. Objective: To evaluate the feasibility, usability, and impact of an in-home telehealth device in the care of CMC. Methods: This single-center feasibility study employed a nonblinded randomized clinical trial design. English-speaking caregivers of children within a pediatric complex care program with home Wi-Fi were eligible for participation. Participants were randomized 1.5:1 with stratification based on tracheostomy status to a control group that received usual care or an intervention group that received a telehealth device for in-home use. Patients were followed up for 4 months. The primary outcome was successful device connectivity and data transmission. Data included clinician encounter device usability; caregiver satisfaction; and encounter type, purpose, and cost. Descriptive statistics, negative binomial regression, and Kaplan–Meier plot were used for analysis. Results: Twenty-four patients were enrolled (9 controls, 15 in the intervention group) in September 2016. The telehealth device was attempted in 73 encounters. Device connectivity was successful 96% of the time. Image and sound quality were acceptable in 98% of visits. Caregivers expressed their overall satisfaction with the device. The hospitalization rate was lower in the intervention group (0.77 vs. 1.14 intensive care unit days/patient-months), resulting in $9,425/USD per patient savings compared with the control group. Conclusion: Despite small sample size and short observation period, this study demonstrated that use of an in-home telehealth device is feasible, well received by caregivers, and can result in decreased hospitalizations when compared with usual care. Mary Ann Liebert, Inc., publishers 2019-11-01 2019-11-06 /pmc/articles/PMC6842894/ /pubmed/30628860 http://dx.doi.org/10.1089/tmj.2018.0186 Text en © Patricia M Notario et al., 2019; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Notario, Patricia M Gentile, Elise Amidon, Matthew Angst, Denise Lefaiver, Cheryl Webster, Kathleen Home-Based Telemedicine for Children with Medical Complexity |
title | Home-Based Telemedicine for Children with Medical Complexity |
title_full | Home-Based Telemedicine for Children with Medical Complexity |
title_fullStr | Home-Based Telemedicine for Children with Medical Complexity |
title_full_unstemmed | Home-Based Telemedicine for Children with Medical Complexity |
title_short | Home-Based Telemedicine for Children with Medical Complexity |
title_sort | home-based telemedicine for children with medical complexity |
topic | Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842894/ https://www.ncbi.nlm.nih.gov/pubmed/30628860 http://dx.doi.org/10.1089/tmj.2018.0186 |
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