Telemed J E Health - International telemedicine consultations for neurodevelopmental disabilities.

Tópicos

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Resumo

CKGROUND: A telemedicine program was developed between the Children's National Medical Center (CNMC) in Washington, DC, and the Sheikh Khalifa Bin Zayed Foundation in the United Arab Emirates (UAE). A needs assessment and a curriculum of on-site training conferences were devised preparatory to an ongoing telemedicine consultation program for children with neurodevelopmental disabilities in the underserved eastern region of the UAE.MATERIALS AND METHODS: Weekly telemedicine consultations are provided by a multidisciplinary faculty. Patients are presented in the UAE with their therapists and families. Real-time (video over Internet protocol; average connection, 768 kilobits/s) telemedicine conferences are held weekly following previews of medical records. A full consultation report follows each telemedicine session.RESULTS: Between February 29, 2012 and June 26, 2013, 48 weekly 1-h live interactive telemedicine consultations were conducted on 48 patients (28 males, 20 females; age range, 8 months-22 years; median age, 5.4 years). The primary diagnoses were cerebral palsy, neurogenetic disorders, autism, neuromuscular disorders, congenital anomalies, global developmental delay, systemic disease, and epilepsy. Common comorbidities were cognitive impairment, communication disorders, and behavioral disorders. Specific recommendations included imaging and DNA studies, antiseizure management, spasticity management including botulinum toxin protocols, and specific therapy modalities including taping techniques, customized body vests, and speech/language and behavioral therapy. Improved outcomes reported were in clinician satisfaction, achievement of therapy goals for patients, and requests for ongoing sessions.CONCLUSIONS: Weekly telemedicine sessions coupled with triannual training conferences were successfully implemented in a clinical program dedicated to patients with neurodevelopmental disabilities by the Center for Neuroscience at CNMC and the UAE government. International consultations in neurodevelopmental disabilities utilizing telemedicine services offer a reliable and productive method for joint clinical programs.

Resumo Limpo

ckground telemedicin program develop children nation medic center cnmc washington dc sheikh khalifa bin zay foundat unit arab emir uae need assess curriculum onsit train confer devis preparatori ongo telemedicin consult program children neurodevelopment disabl underserv eastern region uaemateri method week telemedicin consult provid multidisciplinari faculti patient present uae therapist famili realtim video internet protocol averag connect kilobitss telemedicin confer held week follow preview medic record full consult report follow telemedicin sessionresult februari june week h live interact telemedicin consult conduct patient male femal age rang month year median age year primari diagnos cerebr palsi neurogenet disord autism neuromuscular disord congenit anomali global development delay system diseas epilepsi common comorbid cognit impair communic disord behavior disord specif recommend includ imag dna studi antiseizur manag spastic manag includ botulinum toxin protocol specif therapi modal includ tape techniqu custom bodi vest speechlanguag behavior therapi improv outcom report clinician satisfact achiev therapi goal patient request ongo sessionsconclus week telemedicin session coupl triannual train confer success implement clinic program dedic patient neurodevelopment disabl center neurosci cnmc uae govern intern consult neurodevelopment disabl util telemedicin servic offer reliabl product method joint clinic program

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