Start up to Success: Strategies for Pediatric Inpatient Telemedicine
Kathleen A. Webster, M.D., Director, Division of Pediatric Critical Care
, R. Whit Hall, MD, Professor, Neonatology
, Naomi Fried, PhD, Chief Innovation Officer
Loyola University Health System, Maywood, IL, USA,
University of Arkansas for Medical Sciences, Little Rock, AR, USA,
Children's Hospital Boston, Boston, MA, USA.
Background: Telemedicine has been well established as a means of providing needed subspecialty support for both pediatric and neonatal intensive care units. In establishing such programs, challenges may arise which are unique to the geographic region, the nature of the market place, and the size of the programs involved. This combines with the unique nature of inpatient access which requires 24/7 availability and urgent need for response. Identifying these potential barriers and designing strategies to overcome them is a key component to program success.
Methods: This panel discusses both new and startup programs involving inpatient telehealth programs. Through the example of established programs, we will focus on identification of barriers, recognition of unique factors in the marketplace and geographic region, strategies to gain acceptance and methods of sustaining momentum for established programs. In order to achieve this, we will look at three programs: 1) a startup program using store and forward technology for diagnosis and treatment of retinopathy of prematurity 2) An established program focused on use of telemedicine for connecting specialty and subspecialty physicians to their own hospital to meet quality goals and increase efficiency of care and 3) a tertiary care neonatal intensive care unit that manages a large network of smaller hospitals.
Findings: Barriers encountered include the political and regulatory climate of varied regions and states, infrequent use but urgent need in smaller hospitals and resistance to change by both patients and providers. Strategies for overcoming these barriers include identification and clarification of the unique needs of each providing and receiving center, use for regional coordination and streamlining efficiencies of care, incorporation of quality and educational goals and collection and dissemination of outcomes data to demonstrate utility.
Intent: Through program examples, experienced telehealth providers will discuss implementing, growing and sustaining pediatric inpatient telehealth programs.
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