Telepediatric surgery: capturing clinical outcomes.
OBJECTIVE
The aim of this study is to compare outcomes and patient characteristics of telehealth vs in-person contacts in pediatric surgery ambulatory care patients.


METHODS
All non-Winnipeg telehealth patients (group 1), non-Winnipeg in-person patients (group 2), and a convenience sample of Winnipeg in-person patients (group 3) seen in the pediatric ambulatory surgical clinic and day surgery by one pediatric surgeon in a tertiary urban (Winnipeg, Manitoba) hospital between April 2002 and June 2003 were analyzed.


RESULTS
There were 118, 205, and 120 (total, 443) patients and 153, 427, and 246 (total, 826) patient contacts in groups 1, 2, and 3, respectively. Of 826 patient contacts, 272 were day surgery procedures and 554 were consults and follow-ups, of which 27% (n = 152) were seen via telehealth. Of the non-Winnipeg contacts, 33.4% of consults and 51.5% of follow-ups used telehealth. Variations were seen between the telehealth and the 2 in-person groups on average age at contact, patient no-show rates, intraoperative complication rates, and postoperative complication rates. The interval to consult by telehealth decreased significantly during the course of the study.


CONCLUSIONS
This is the first comparative analysis of telehealth outcomes in a population of pediatric surgery ambulatory care patients. Telehealth improves access to pediatric surgical services without untoward clinical outcomes.
Postuma
Ray
R
Section of Pediatric General Surgery, Winnipeg Children's Hospital, Winnipeg, MB, Canada R3A 1S1. postuma@ms.umanitoba.ca
Loewen
Liz
L
D000367:Age Factors; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D003953:Diagnosis-Related Groups; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D020407:Internet; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008350:Manitoba; D010372:Pediatrics / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D019114:Remote Consultation / Q000379:methods / Q000706:statistics & numerical data; D018855:Single-Payer System; D013531:Surgicenters / Q000706:statistics & numerical data; D017216:Telemedicine / Q000191:economics / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data*; D016896:Treatment Outcome