title: Four years of experience of telemedicine for paediatric care in three Punjab hospitals, North India: achievements and lessons.
abstract: Children in India constitute a very high risk group from mortality and morbidity due to lack of specialised healthcare. Remote care of paediatric patients by offsite specialists using telemedicine technology is a highly potential solution for coping up with the shortage of specialists in Indian subcontinent. We at a tertiary care teaching hospital in North India assessed the application of telemedicine services for diagnosis and management of paediatric illnesses, through prospective analyses of electronic databases over 4 years. The age groups covered were from newborn up to children of 15 years of age. The outcomes assessed were: feasibility, diagnostic possibilities, management, outcomes, referral and mean costs per patient. The results were as follows: major consultations involved children <5 years age, with neonates contributing to 5.5% of the total consultations. The major system-related problems were: gastrointestinal, respiratory, neurological, infectious and haematological. Referral was advised in 14.3% of cases. Ten percent of children were critically ill and could not have been in a position to be transported safely. Videoconferencing was done in 21.4% patients. There was a paucity of feedback and follow up of these consultations (12% of the total). The total savings for all the consultations per child was ≈1000 Indian rupees (approximately US$22) leaving behind the telemedicine consultation charges. To conclude, telepaediatrics in India is still in its fetal stage. The hurdles and medico-legal issues need to be addressed before the telepaediatrics service is widely accepted in India.
authors.affiliation: Advanced Pediatric Centre, Post-Graduate Institute of Medical Education & Research, Chandigarh, India. meenusingh4@gmail.com
authors.forename: Meenu
authors.initials: M
authors.lastname: Singh
authors.forename: Rashmi Ranjan
authors.initials: RR
authors.lastname: Das
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration*; D002675:Child, Preschool; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019114:Remote Consultation / Q000458:organization & administration / Q000706:statistics & numerical data / Q000639:trends; D017216:Telemedicine / Q000191:economics / Q000458:organization & administration*