Telemedicine appointments combined with in-person visits significantly reduced the risk of further illness for children with medically complex cases, according to results of a new study by researchers with The University of Texas Health Science Center at Houston (UTHealth).
The study was published today in Pediatrics.
Children with medically complex cases require intense care supervision for conditions like genetic diseases, feeding difficulties, and developmental delays. These children often rely on technology such as feeding tubes or tracheostomies – a tube inserted in the throat to help provide air in the lungs.
“In the beginning, we were concerned about seeing the children through telemedicine instead of in the clinic,” said Ricardo Mosquera, MD, associate professor of pulmonary medicine at McGovern Medical School at UTHealth and corresponding author on the study. “Most of these patients have feeding tubes or tracheostomies, so we didn’t know how it would go. But, I think what we found is promising. I think providers can feel comfortable knowing that telemedicine appointments are just as effective. They don’t always have to bring high-risk patients in to the clinic.”
Using a randomized approach, researchers assessed 422 patients between 2018 and 2020. Half of the patients in the study received traditional care and the other half received comprehensive care plus telemedicine visits.
Patients who received both telemedicine and comprehensive care were 99% less likely to need additional care for serious illness outside of their home compared to those who just received traditional care.
Mosquera, a pediatric pulmonologist at UT Physicians High Risk Children’s Clinic, says reducing exposures to high-risk children is especially important during the current COVID-19 pandemic and other outbreaks of contagious and seasonal illnesses.
“Children with medically complex cases are at a higher risk of becoming severely ill. So, being able to assess these patients from their home, where they are less likely to be exposed to public areas or other critically ill patients, is important in reducing their risk. With telemedicine, we are able to provide care a lot faster. We are more proactive with prescribing medication right then and there. If a patient needs a quick telemedicine appointment Friday afternoon, I will assess them and they don’t have to wait the weekend to be seen, and there is no delay in getting the medication they need,” he said.
Mosquera says telemedicine should not replace critical in-person visits.
“Some appointments will still need to be in person. But this assures providers and even parents that they can do both in person and telemedicine. Patients don’t have to be seen solely in person to have good results. The results will be the same or even better because they are less likely to have further illnesses when they do both,” Mosquera said.
Additional authors with McGovern Medical School at UTHealth included Jon Tyson, MD, MPH, professor of pediatrics, obstetrics and internal medicine, and the Michelle Bain Distinguished Professorship in Medicine and Public Health; Elenir Avritscher, MD, associate professor of pediatrics; Claudia Pedroza, PhD, associate professor of pediatrics; Tomika S. Harris, RN, pediatric nurse practitioner; Kyung Hyun Lee, PhD, research fellow with the Center for Clinical Research and Evidence Based Medicine; Michelle Poe, PhD, research nurse with the Center for Clinical Research and Evidence Based Medicine; Supriya Ramanathan, MD, pulmonary medicine staff physician; Maria Caldas-Vasquez, MD, pulmonary medicine staff physician; Julie Eapen, MD, assistant professor of pulmonary medicine; Aravind Yadav, MD, assistant professor of pulmonary medicine; Diana Martinez Castillo, B.S.; and Matthew T. Harting, MD, associate professor of pediatric surgery. Other authors include Madelene J. Ottosen, PhD, assistant professor of nursing research with Cizik School of Nursing at UTHealth; and Teddy Gonzalez, MD, with MasterWord Services Translation & Interpretation.
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