A recent study has found that video telehealth consultations were more effective than telehealth-based consultations, due to their ability to prevent needless pediatric hospital transfers for patients and their families. The study was released by JAMA network open, where it was also discovered that interfacility transfers may not always be necessary, but since many rural emergency rooms lack pediatric specialized care physicians, they are highly necessary in some cases. Authors of the study placed emphasis on the impact of telehealth and telephone consultations on interfacility transfer rates with the aim of providing pediatric patients with comprehensive treatment while limiting needless transfers. Between November 18, 2015, and March 26, 2018, researchers carried out a cluster-randomized crossover experiment. Analysis was done between January of 2018, and July of 2022. Children aged fourteen or younger who are diagnosed with acute illnesses, and sought care at one of fifteen rural or community emergency rooms in northern California were integrated by researchers into the study. To analyze interfacility transfers, researchers mandated that all emergency rooms interact with pediatric critical care physicians via either telephone or telemedicine services. 392 males out of the 696 kids who were a part of the study had a mean age of approximately four years old. Slightly less than thirty six percent of patients, 251 individuals, had video telehealth consultations, while sixty four percent, 445 individuals, had telephone consultations.
Several key metrics were employed by the researchers to assess the risk of transfer:
- Intention-to-treat
- treatment-received
- per-protocol analyzes
Researchers also discovered that in the intention-to-treat analysis, those who participated in a video telehealth consultation had a reduced chance of being transferred than those in the telephone group after correcting for the following:
- patient age
- disease severity
- hospital study duration
The researchers commented on this stating: ‘In the adjusted intention-to-treat analysis, we found that consultations allocated to telemedicine resulted in a significantly lower risk of transfer to a pediatric referral center than those allocated to telephone, which is the current standard of care’. In comparison to 90.6 percent of patients assigned to telephone consultations, eighty four percent of patients getting video telehealth consultations were moved to UC Davis Children’s Hospital. In both the treatment-received analysis and the per-protocol analysis, It was discovered that the adjusted risk of transfer was mitigated in the telehealth group with respect to the telephone group. It is clear from 2022, and the beginning of this year, that telehealth services are being used more frequently by provider groups to provide access to pediatric care. It was concluded that several other benefits exist from availing of telehealth for healthcare treatment of this nature.
“Using telemedicine with a remote pediatric specialist provides local physicians and families with more support, both clinically and emotionally, than a standard telephone conversation and could result in lower levels of parental distress.36,37 In addition, telemedicine can be used to include the referring bedside nurse, which could increase their confidence in caring for children in their own EDs.”
