title: Use of telemedicine for children with special health care needs.
abstract: OBJECTIVE
  In 1995, the Children's Medical Services (CMS) of the State of Georgia contracted with the Department of Pediatrics of the Medical College of Georgia (MCG) and the MCG Telemedicine Center to develop telemedicine programs to provide subspecialty care for children with special health care needs. This article presents project statistics and results of client evaluation of services, as well as physician faculty attitudes toward telemedicine.
  
  
  METHODS
  A demonstration project using telemedicine between a tertiary center and a rural clinic serving children with special health care needs was established. 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 allergy/immunology. Other subspecialties included pulmonology (29%), neurology (19%), and genetics (16%). Overall, patients were satisfied with the services received. Initially, physician faculty members were generally positive but conservative in their attitudes toward using telemedicine for delivering clinical consultation. After a year's exposure and/or experience with telemedicine, 28% were more positive, 66% were the same, and only 4% were more negative 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 consultation services to children with special health care needs, living in rural areas distant to tertiary centers. Telemedicine is more likely to be successful as part of an integrated health services delivery than when it is the sole mode used for delivery of care.
authors.affiliation: Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912, USA. wkarp@mail.mcg.edu
authors.forename: W B
authors.initials: WB
authors.lastname: Karp
authors.forename: R K
authors.initials: RK
authors.lastname: Grigsby
authors.forename: M
authors.initials: M
authors.lastname: McSwiggan-Hardin
authors.forename: S
authors.initials: S
authors.lastname: Pursley-Crotteau
authors.forename: L N
authors.initials: LN
authors.lastname: Adams
authors.forename: W
authors.initials: W
authors.lastname: Bell
authors.forename: M E
authors.initials: ME
authors.lastname: Stachura
authors.forename: W P
authors.initials: WP
authors.lastname: Kanto
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D019988:Children with Disabilities; D005260:Female; D005845:Georgia; D006801:Humans; D007223:Infant; D008297:Male; D019114:Remote Consultation; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine