Telemed J E Health - Barriers and facilitators to pediatric emergency telemedicine in the United States.

Tópicos

{ patient(1821) servic(1111) care(1106) }
{ howev(809) still(633) remain(590) }
{ care(1570) inform(1187) nurs(1089) }
{ implement(1333) system(1263) develop(1122) }
{ patient(2837) hospit(1953) medic(668) }
{ use(976) code(926) identifi(902) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ intervent(3218) particip(2042) group(1664) }
{ survey(1388) particip(1329) question(1065) }
{ inform(2794) health(2639) internet(1427) }
{ method(1557) propos(1049) approach(1037) }
{ general(901) number(790) one(736) }
{ state(1844) use(1261) util(961) }
{ use(1733) differ(960) four(931) }
{ learn(2355) train(1041) set(1003) }
{ design(1359) user(1324) use(1319) }
{ studi(1119) effect(1106) posit(819) }
{ medic(1828) order(1363) alert(1069) }
{ cost(1906) reduc(1198) effect(832) }
{ time(1939) patient(1703) rate(768) }
{ health(1844) social(1437) communiti(874) }
{ data(1714) softwar(1251) tool(1186) }
{ system(1050) medic(1026) inform(1018) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ monitor(1329) mobil(1314) devic(1160) }
{ research(1218) medic(880) student(794) }
{ age(1611) year(1155) adult(843) }
{ sampl(1606) size(1419) use(1276) }
{ activ(1138) subject(705) human(624) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ high(1669) rate(1365) level(1280) }
{ decis(3086) make(1611) patient(1517) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ model(3480) simul(1196) paramet(876) }
{ ehr(2073) health(1662) electron(1139) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ analysi(2126) use(1163) compon(1037) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Pediatric emergency telemedicine has the potential to improve the quality of pediatric emergency care in underserved areas, reducing socioeconomic disparities in access to care. Yet, telemedicine in the pediatric emergency setting remains underutilized. We aimed to assess the current state of pediatric emergency telemedicine and identify unique success factors and barriers to widespread use.MATERIALS AND METHODS: We conducted a telephone survey of current, former, and planned pediatric emergency telemedicine programs in the United States.RESULTS: We surveyed 25 respondents at 20 unique sites, including 12 current, 5 planned, and 3 closed programs. Existing programs were located primarily in academic medical centers and served an average of 12.5 spoke sites (range, 1-30). Respondents identified five major barriers, including difficulties in cross-hospital credentialing, integration into established workflows, usability of technology, lack of physician buy-in, and misaligned incentives between patients and providers. Uneven reimbursement was also cited as a barrier, although this was not seen as major because most programs were able to operate independent of reimbursement, and many were not actively seeking reimbursement even when allowed. Critical success factors included selecting spoke hospitals based on receptivity rather than perceived need and cultivating clinical champions at local sites.CONCLUSIONS: Although pediatric emergency telemedicine confronts many of the same challenges of other telemedicine applications, reimbursement is relatively less significant, and workflow disruption are relatively more significant in this setting. Although certain challenges such as credentialing can be addressed with available policy options, others such as the culture of transfer at rural emergency departments require innovative approaches.

Resumo Limpo

ckground pediatr emerg telemedicin potenti improv qualiti pediatr emerg care underserv area reduc socioeconom dispar access care yet telemedicin pediatr emerg set remain underutil aim assess current state pediatr emerg telemedicin identifi uniqu success factor barrier widespread usemateri method conduct telephon survey current former plan pediatr emerg telemedicin program unit statesresult survey respond uniqu site includ current plan close program exist program locat primarili academ medic center serv averag spoke site rang respond identifi five major barrier includ difficulti crosshospit credenti integr establish workflow usabl technolog lack physician buyin misalign incent patient provid uneven reimburs also cite barrier although seen major program abl oper independ reimburs mani activ seek reimburs even allow critic success factor includ select spoke hospit base recept rather perceiv need cultiv clinic champion local sitesconclus although pediatr emerg telemedicin confront mani challeng telemedicin applic reimburs relat less signific workflow disrupt relat signific set although certain challeng credenti can address avail polici option other cultur transfer rural emerg depart requir innov approach

Resumos Similares

Telemed J E Health - The Maniapure Program--lessons learned from a rural experience: two decades delivering primary healthcare through telemedicine. ( 0,778904433062656 )
AMIA Annu Symp Proc - Implementation of an electronic referral system for outpatient specialty care. ( 0,755643304454629 )
J Telemed Telecare - A tele-oncology model replacing face-to-face specialist cancer care: perspectives of patients in North Queensland. ( 0,736313622183542 )
Telemed J E Health - Smartphone surgery: how technology can transform practice. ( 0,722706396283557 )
Med Decis Making - Hic sunt dracones: the future of health technology assessment--one economist's perspective. ( 0,71031146188229 )
AMIA Annu Symp Proc - Supporting information use and retention of pre-hospital information during trauma resuscitation: a qualitative study of pre-hospital communications and information needs. ( 0,708131942124931 )
Telemed J E Health - An independent investigation into the deployment of the federal communications commissions' rural health care pilot program. ( 0,702392846121902 )
Int J Med Inform - Multi-professional patterns and methods of communication during patient handoffs. ( 0,691545828920765 )
J Telemed Telecare - Use of home telehealth in palliative cancer care: a case study. ( 0,68004736851463 )
J Innov Health Inform - Using information to deliver safer care: a mixed-methods study exploring general practitioners' information needs in North West London primary care. ( 0,677765082415005 )
J Telemed Telecare - A telephone survey of patient satisfaction with realtime telemedicine in a rural community in Colombia. ( 0,667420351307855 )
Telemed J E Health - Engaging patients via mobile phone technology to assist follow-up after hospitalization in Quito, Ecuador. ( 0,665066389555729 )
J. Med. Internet Res. - Primary care providers' perspectives on online weight-loss programs: a big wish list. ( 0,664124930371889 )
J. Med. Internet Res. - The Computer-Assisted Brief Intervention for Tobacco (CABIT) program: a pilot study. ( 0,663568934150745 )
J Telemed Telecare - Patients' experiences of telerehabilitation at home after shoulder joint replacement. ( 0,662724317151383 )
J Telemed Telecare - Practical experience of telehealth between an Antarctic station and Japan. ( 0,655446745135393 )
Int J Med Inform - Paper persistence, workarounds, and communication breakdowns in computerized consultation management. ( 0,654327647535094 )
Healthc (Amst) - Innovating in health delivery: The Penn medicine innovation tournament. ( 0,649750936900167 )
Int J Med Inform - Teleconsultation in geriatrics: impact on professional practice. ( 0,644036471914045 )
AMIA Annu Symp Proc - Coordination of care for complex pediatric patients: perspectives from providers and parents. ( 0,641968977988278 )
Telemed J E Health - Online medical care: the current state of eVisits in acute primary care delivery. ( 0,64080390212584 )
AMIA Annu Symp Proc - Who are portal users vs. early e-Visit adopters? A preliminary analysis. ( 0,639935292193784 )
J Am Med Inform Assoc - The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals. ( 0,636922196570961 )
J Telemed Telecare - Integration of e-consultations into the outpatient care process at a tertiary medical centre. ( 0,632069022567636 )
BMC Med Inform Decis Mak - Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence. ( 0,631629816309069 )
J Telemed Telecare - The role of the champion in telehealth service development: a qualitative analysis. ( 0,631386291147225 )
Telemed J E Health - The impact of modern telecommunication in palliative care--the views of the professionals. ( 0,630764352921458 )
Telemed J E Health - Teledermatology operational considerations, challenges, and benefits: the referring providers' perspective. ( 0,630423463168903 )
J Telemed Telecare - A pilot study of the effectiveness of home teleconsultations in paediatric palliative care. ( 0,62861248215573 )
J Telemed Telecare - Cost savings and safety of ICD remote control by telephone: a prospective, observational study. ( 0,624935999060918 )
J Telemed Telecare - Telehealth in palliative care in the UK: a review of the evidence. ( 0,624654044419087 )
J Telemed Telecare - Experience with telehealth for sleep monitoring and sleep laboratory management. ( 0,624070280725098 )
J Telemed Telecare - Telehealth for nursing homes: the utilization of specialist services for residential care. ( 0,622978085421353 )
Telemed J E Health - Home telehealth: facilitators, barriers, and impact of nurse support among high-risk dialysis patients. ( 0,617683356905472 )
J Telemed Telecare - Use of videoconferencing for consultation in dental prosthetics and oral rehabilitation. ( 0,617566217397846 )
Telemed J E Health - Testing a top-down strategy for establishing a sustainable telemedicine program in a developing country: the Arizona telemedicine program-US Army-Republic of Panama Initiative. ( 0,617532539708342 )
Healthc (Amst) - An exploration of management practices in hospitals. ( 0,61517624475441 )
J Telemed Telecare - Eleven years of experience with low-bandwidth telemedicine in a nurse-led rural clinic in Scotland. ( 0,61462470499378 )
BMC Med Inform Decis Mak - Questionnaire survey about use of an online appointment booking system in one large tertiary public hospital outpatient service center in China. ( 0,61278919150091 )
J Med Syst - Design and development of a Telephone-Linked Care (TLC) system to reduce impulsivity among violent forensic outpatients and probationers. ( 0,612518679926503 )
Telemed J E Health - Telemedicine in an academic center--the Arizona Telemedicine Program. ( 0,612202913680251 )
J Telemed Telecare - The benefits of e-health support for older family caregivers in rural areas. ( 0,611970055902518 )
Telemed J E Health - Content and style comparison of physician communication in teledermatology and in-person visits. ( 0,610698379229345 )
Appl Clin Inform - An e-health decision support system for improving compliance of health workers to the maternity care protocols in South Africa. ( 0,607790142482642 )
J Telemed Telecare - Need and feasibility of telemedicine in non-urban day care centres. ( 0,605903163936117 )
Telemed J E Health - Giving voice: Evaluation of an integrated telehealth community care model by parents/guardians of children diagnosed with fetal alcohol spectrum disorder in Manitoba. ( 0,605752561130273 )
Telemed J E Health - State primary stroke center policies in the United States: rural health issues. ( 0,605267172886915 )
AMIA Annu Symp Proc - Participatory Design and Development of a Patient-centered Toolkit to Engage Hospitalized Patients and Care Partners in their Plan of Care. ( 0,604648484475032 )
Telemed J E Health - Using telehealth for assessment of fetal alcohol spectrum disorder: the experience of two Canadian rural and remote communities. ( 0,604075561843337 )
Telemed J E Health - Telemedicine in acute-phase injury management: a review of practice and advancements. ( 0,603403395939058 )
J Telemed Telecare - A qualitative study of ethical, medico-legal and clinical governance matters in Australian telehealth services. ( 0,602185365483081 )
Telemed J E Health - Acceptability of the consumer-centric u-health services for patients with chronic obstructive pulmonary disease. ( 0,601663902848134 )
Telemed J E Health - Utilization, benefits, and impact of an e-consultation service across diverse specialties and primary care providers. ( 0,601604617967764 )
Telemed J E Health - Teledermatology patient satisfaction in the Pacific Northwest. ( 0,600110171098205 )
Telemed J E Health - A pilot project to improve access to telepsychotherapy at rural clinics. ( 0,599100364970512 )
Int J Med Inform - Tablet computers in support of rural and frontier clinical practice. ( 0,596831344492106 )
Telemed J E Health - Can an office practice telephonic response meet the needs of a pandemic? ( 0,594891499202624 )
Telemed J E Health - Private payer telehealth reimbursement in the United States. ( 0,593202944277548 )
J Telemed Telecare - A feasibility study of a telephone-based screening service for mild cognitive impairment and its uptake by elderly people. ( 0,592698270483062 )
BMC Med Inform Decis Mak - A dialogue-based Web application enhances personalized access to healthcare professionals--an intervention study. ( 0,592226600455153 )
Telemed J E Health - Technologies in the patient-centered medical home: examining the model from an enterprise perspective. ( 0,591672844232618 )
J Biomed Inform - Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis. ( 0,59116847117798 )
Telemed J E Health - Providers' perspectives: utilizing telepsychiatry in schools. ( 0,589864616407374 )
BMC Med Inform Decis Mak - The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments. ( 0,589482732783916 )
Telemed J E Health - Primary care provider and imaging technician satisfaction with a teledermatology project in rural Veterans Health Administration clinics. ( 0,58559321507214 )
Telemed J E Health - Evaluating the uptake, acceptability, and effectiveness of Uliza! clinicians' HIV hotline: a telephone consultation service in Kenya. ( 0,58509105441759 )
J. Med. Internet Res. - Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study. ( 0,585040680022571 )
Telemed J E Health - Improving stroke outcomes in rural areas through telestroke programs: an examination of barriers, facilitators, and state policies. ( 0,584136341762198 )
J Telemed Telecare - Use of a mental health emergency care-rural access programme in emergency departments. ( 0,583378935348761 )
Telemed J E Health - Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review. ( 0,58231673465999 )
Telemed J E Health - Teleconcussion: an innovative approach to screening, diagnosis, and management of mild traumatic brain injury. ( 0,582265458996329 )
J. Med. Internet Res. - An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study. ( 0,582229860987488 )
J. Med. Internet Res. - Occupational therapists' views on using a virtual reality interior design application within the pre-discharge home visit process. ( 0,582080909094674 )
Telemed J E Health - A pilot trial of telephone-based collaborative care management for PTSD among Iraq/Afghanistan war veterans. ( 0,581211849719766 )
Telemed J E Health - Telemedicine in Alentejo. ( 0,581173073486675 )
J Telemed Telecare - Effectiveness and safety of telemedical management in uncomplicated urinary tract infections. ( 0,580876820003432 )
Int J Med Inform - Bridging two translation gaps: a new informatics research agenda for telemonitoring of chronic disease. ( 0,580867476539106 )
Telemed J E Health - The design, implementation, and operational management of a comprehensive quality management program to support national telehealth networks. ( 0,580014044783533 )
J Telemed Telecare - Safety for home care: the use of internet video calls to double-check interventions. ( 0,579133606966276 )
J Telemed Telecare - Telemedicine in the Solomon Islands: 2006 to 2009. ( 0,579043110455085 )
Int J Med Inform - Going paperless at the emergency department: a socio-technical study of an information system for patient tracking. ( 0,578010533283365 )
Int J Med Inform - Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow. ( 0,575288593050994 )
Int J Med Inform - Health information exchange interventions can enhance quality and continuity of HIV care. ( 0,575100912118293 )
Telemed J E Health - Telehealth practice recommendations for diabetic retinopathy, second edition. ( 0,574236262431097 )
BMC Med Inform Decis Mak - Quality of prenatal and maternal care: bridging the know-do gap (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa. ( 0,573090701515035 )
J Am Med Inform Assoc - The impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature. ( 0,573022682628108 )
Telemed J E Health - Video-telemedicine in a memory disorders clinic: evaluation and management of rural elders with cognitive impairment. ( 0,572982406702972 )
AMIA Annu Symp Proc - Characterization of a handoff documentation tool through usage log data. ( 0,572831208315625 )
AMIA Annu Symp Proc - Computerization of Mental Health Integration complexity scores at Intermountain Healthcare. ( 0,572033615819139 )
Telemed J E Health - Teleneurology: successful delivery of chronic neurologic care to 354 patients living remotely in a rural state. ( 0,570646195356452 )
Comput. Biol. Med. - Suggestions for a web based universal exchange and inference language for medicine. Continuity of patient care with PCAST disaggregation. ( 0,570295999333725 )
BMC Med Inform Decis Mak - Design of a randomized, non-inferiority trial to evaluate the reliability of videoconferencing for remote consultation of diabetes. ( 0,569410011198834 )
Telemed J E Health - Ten steps to establishing an e-consultation service to improve access to specialist care. ( 0,568985703708202 )
Int J Med Inform - Setting up a telemedicine service for remote real-time video-EEG consultation in La Rioja (Spain). ( 0,567470334824589 )
J Telemed Telecare - Integrating telemedicine instruction into the curriculum: expanding student perspectives of the scope of clinical practice. ( 0,567395929119267 )
Telemed J E Health - PsychVACS: a system for asynchronous telepsychiatry. ( 0,566054069774907 )
BMC Med Inform Decis Mak - Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective. ( 0,565716220326929 )
J. Med. Internet Res. - Video consultation use by Australian general practitioners: video vignette study. ( 0,564627352619717 )
Telemed J E Health - Comparison of parent satisfaction with care for childhood obesity delivered face-to-face and by telemedicine. ( 0,564083631814565 )
Int J Med Inform - Organisational influences on nurses' use of clinical decision support systems. ( 0,563460858915955 )