Value

ePoster Presentation

(EP-148) The Feasibility and Satisfaction of Using Telemedicine to Provide Tertiary Pediatric Obesity Care

Sunday, April 23
4:55 PM - 5:10 PM
Location: Experience Zone - ePosters

Objectives
The use of telemedicine in Pediatric tertiary obesity care is in its infancy. Although Telemedicine implementation in tertiary care has been tried, the satisfaction and outcome data is limited largely due to small sample sizes and the marked variation of methods and personnel by which the telemedicine technology is delivered and participants assessed. Few studies have examined the feasibility of telemedicine pediatric tertiary obesity care for both initial assessments and follow up visits. None have utilized a telemedicine cart with customizable diagnostic medical equipment. Few have assessed the perceptions of specialist provider, staff and patients at the same visit. Our objective was to determine the feasibility of using telemedicine to deliver Pediatric tertiary obesity care and to evaluate Patient/MD/Staff satisfaction.

Methods
We used a commercially available telemedicine system by JEMS technology to conduct a prospective study where a sample of 30 patients were evaluated by a specialist physician using telemedicine technology from February 2016 through August 2016. Inclusion criteria included children aged 10-18 years of age and a BMI greater than 95%, either as an initial assessment or as follow up. A qualitative assessment of the patient/MD/staff perceptions of telemedicine use were assessed through a 5 point Likert scale. Technology problems were documented for each session. Patients were financially compensated for their participation. The study was approved by the Institutional Review Board at the University of South Alabama. Consent was obtained from patients’ guardians. We used descriptive statistics when appropriate. We used a Wilcoxon signed rank test to determine differences between Physician, RN/CRNPs/Residents and patients survey responses.

Results
One specialist physician (DP), along with CRNP/RN/PA/Resident performed 30 telemedicine consultations. 27 (90%) consultations were performed to completion, 3 (10%) sessions were incomplete due to wireless connections issues. 15 consultations were initial assessments. Fifty-seven percent of the patients were female, 70% were African American. The average age of the patient was 14.5 years ±2.4. Technology error troubleshooting was the most common cause of incomplete sessions and technology dissatisfaction.
MD, staff and patient responders agreed that the use of telemedicine is an appropriate and effective use of the clinician’s skillset and time (≥96%), and can avoid patient travel from an underserved area to a tertiary care clinic (≥95%). All responders were comfortable and satisfied using the Telemedicine equipment (≥85%). MD and patients agreed that the telemedicine equipment helped the patient avoid a face-to-face visit (≥90%) Specialist MD and patients felt the technology was effective in the management of their visit (≥93%).


Conclusion
We successfully delivered tertiary obesity care through the use of telemedicine equipment in different clinical situations and pathologies associated with Pediatric Obesity. Wireless internet connectivity and adequate training of personnel to use the equipment are important aspects of successfully completing telemedicine sessions with patient, staff and physician satisfaction. Access to pediatric tertiary obesity care is a major barrier specifically for minorities and low socioeconomic populations, in our opinion telemedicine represents a realistic, successful and cost-effective modality to provide well-received specialty care for the obese pediatric population.

Reza Sadeghian

Resident Physician
University of South Alabama

Reza Sadeghian MD MBA MSc is currently finishing a Pediatric Residency at the University of South Alabama, board eligible in July of 2017. Previous to this he completed his Masters of Science in a NLM-funded post doctoral program in the Department of Biomedical Informatics of the University of Pittsburgh. His research focus there was on telemedicine and its feasibility in the nursing home setting and is currently leading a telemedicine study at the University of South Alabama Children and Women’s Hospital’s Adolescent Medicine Clinic. He received a Masters degree in business administration with a concentration in health care administration from Auburn University and is currently a fellow candidate in the American College of Healthcare Executives (ACHE). He has extensive experience as a health care consultant, having held various positions such as director of information technology services and managing consultant, leading various clinical operations including ICD-10 implementation. My interdisciplinary research focuses on a variety of studies including meaningful use of advanced telemedicine technology, education, quality improvement, care management, clinical and translational informatics to improve patient care, and reduce health care cost in a variety of clinical settings.

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LeighAnn Phelps

Clinical RN
University of South Alabama

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Daniel Preud'homme

Professor of Adolescent Medicine, Medical director of Pediatric health life center
University of South Alabama

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Rebecca Gooch

Director of Evidence based intensive care practice
Northwell Hofstra School of Medicine

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(EP-148) The Feasibility and Satisfaction of Using Telemedicine to Provide Tertiary Pediatric Obesity Care



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