Telemedicine in pediatric primary care. Favorable experience in nurse-staffed inner-city clinic.
Off-site pediatric consultation via bidirectional cable television (TV) was instituted to provide backup for nurse practitioners treating sick and well children in a small primary-care clinic. During a year of study of the system, there were 2,161 clinic visits and 285 TV consultations. When both TV and telephone consultation were available, TV was used for 10.8% of the visits, and telephone was used for 9.6% of visits. Staff reactions, though initially skeptical, were ultimately favorable. The system allowed pediatric nurse practitioners to function without on-site physician coverage 40% of the time. The main disadvantages were technical. Further work is needed to assess the reliability and validity of TV consultation and its acceptability in other settings.
D001291:Attitude of Health Personnel; D002648:Child; D003151:Community Health Centers / Q000458:organization & administration*; D003365:Costs and Cost Analysis; D003657:Decision Making; D006801:Humans; D009519:New York City; D009722:Nurse Practitioners; D010342:Patient Acceptance of Health Care; D010371:Pediatric Nursing / Q000191:economics; D011320:Primary Health Care; D013689:Telephone; D013690:Television; D014504:Urban Health; D014743:Videotape Recording