Use of telemedicine for children with special health care needs

Objective. In 1995,the Children's Medical Services (CMS) of the State of Ge orgia contracted with the Department of Pediatrics of the Medical College o f Georgia (MCG) and the MCG Telemedicine Center to develop telemedicine pro grams to provide subspecialty care for children with special health care ne eds. This article presents project statistics and results of client evaluat ion of services, as well as physician faculty attitudes toward telemedicine . Design. A demonstration project using telemedicine between a tertiary cente r and a rural clinic serving children with special health care needs was es tablished. Data were collected and analyzed for December 12, 1995 to May 31 , 1997, during which 333 CMS telemedicine consultations were performed. Results. Most CMS telemedicine consultations (35%) involved pediatric aller gy/immunology. Other subspecialties included pulmonology (29%), neurology ( 19%), and genetics (16%). Overall, patients were satisfied with the service s received. Initially, physician faculty members were generally positive bu t conservative in their attitudes toward using telemedicine for delivering clinical consultation. After a year's exposure and/or experience with telem edicine, 28% were more positive, 66% were the same, and only 4% were more n egative about telemedicine. The more physicians used telemedicine, the more positive they were about it (r =.30). Conclusions. In terms of family attitudes and individual care, telemedicine is an acceptable means of delivering specific pediatric subspecialty consu ltation services to children with special health care needs, living in rura l areas distant to tertiary centers. Telemedicine is more likely to be succ essful as part of an integrated health services delivery than when it is th e sole mode used for delivery of care.