The impact of telemedicine intensivist support and a pediatric hospitalist program on a community hospital

Jaclin M. LaBarbera, Miles Ellenby, Paul Bouressa, Jill Burrell, Heidi R. Flori, James P. Marcin

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Because of centralization of care, pediatric patients often require transfer for subspecialty care. We evaluated the impact of telemedicine critical care consultation and a pediatric hospitalist program on enabling patients to remain at a community hospital. Patients and Methods: This is a retrospective chart review of pediatric patients at a community hospital receiving critical care consultation from a tertiary children's hospital from January 2006 to October 2009. Patient cohorts differed by modality of intensivist consultation (telephone versus telemedicine) and modality of inpatient ward care at the community hospital (primary care physician versus hospitalist). Patients were compared for differences in transfer rate and rate of diversion from the pediatric intensive care unit to the tertiary ward. Results: One hundred fifty-three charts were analyzed: 41 from prior to hospitalist and telemedicine implementation (Cohort 1), 56 from post-implementation of telemedicine but pre-hospitalist program (Cohort 2), and 56 after implementation of both the telemedicine and hospitalist programs (Cohort 3). Baseline data did not differ among cohorts. Transfer rates after intensivist consultation were lower after implementation of telemedicine consultation (100%, 85.7%, and 87.5% in Cohorts 1-3, respectively; p=0.04). The proportion of transferred patients who were diverted to the tertiary ward decreased over time (19.5%, 14.5%, and 6.1% in Cohorts 1-3, respectively; p=0.003). Conclusions: Telemedicine consultation between pediatric intensivists and community hospital physicians combined with a pediatric hospitalist program at the community hospital has the potential to improve triage of pediatric patients and reduce the need to transfer patients.

Original languageEnglish (US)
Pages (from-to)760-766
Number of pages7
JournalTelemedicine and e-Health
Volume19
Issue number10
DOIs
StatePublished - Oct 1 2013

Fingerprint

Hospitalists
Telemedicine
Community Hospital
Pediatrics
Referral and Consultation
Critical Care
Patient Transfer
Pediatric Intensive Care Units
Pediatric Hospitals
Triage
Primary Care Physicians
Telephone
Tertiary Care Centers
Inpatients
Patient Care
Physicians

Keywords

  • child
  • critical care
  • hospitalist
  • remote consultation
  • telemedicine
  • triage

ASJC Scopus subject areas

  • Medicine(all)
  • Health Informatics
  • Health Information Management

Cite this

The impact of telemedicine intensivist support and a pediatric hospitalist program on a community hospital. / LaBarbera, Jaclin M.; Ellenby, Miles; Bouressa, Paul; Burrell, Jill; Flori, Heidi R.; Marcin, James P.

In: Telemedicine and e-Health, Vol. 19, No. 10, 01.10.2013, p. 760-766.

Research output: Contribution to journalArticle

LaBarbera, Jaclin M. ; Ellenby, Miles ; Bouressa, Paul ; Burrell, Jill ; Flori, Heidi R. ; Marcin, James P. / The impact of telemedicine intensivist support and a pediatric hospitalist program on a community hospital. In: Telemedicine and e-Health. 2013 ; Vol. 19, No. 10. pp. 760-766.
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