Using Video from Mobile Phones to Improve Pediatric Phone Triage in an Underserved Population.
Video-capable mobile phones are widely available, but few studies have evaluated their use in telephone triage for pediatric patients. We assessed the feasibility, acceptability, and utility of videos sent via mobile phones to enhance pediatric telephone triage for an underserved population with asthma.



We recruited children who presented to an urban pediatric emergency department with an asthma exacerbation along with their parent/guardian. Parents and the research team each obtained a video of the child's respiratory exam, and the research team conducted a concurrent in-person rating of respiratory status. We measured the acceptability of families sending videos as part of telephone triage (survey) and the feasibility of this approach (rates of successful video transmission by parents to the research team). To estimate the utility of the video in appropriately triaging children, four clinicians reviewed each video and rated whether they found the video reassuring, neutral, or raising concerns.



Among 60 families (78% Medicaid, 85% Black), 80% of parents reported that sending a video would be helpful and 68% reported that a nurse's review of a video would increase their trust in the triage assessment. Most families (75%) successfully transmitted a video to the research team. All clinician raters found the video reassuring regarding the severity of the child's asthma exacerbation for 68% of children.



Obtaining mobile phone videos for telephone triage is acceptable to families, feasible, and may help improve the quality of telephone triage in an urban, minority population.
1 Department of Pediatrics, University of Colorado School of Medicine , Aurora, Colorado.
Brandi
B
Freeman
2 Center for Pediatric Clinical Effectiveness , The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.|3 PolicyLab, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
Stephanie
S
Mayne
4 Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.
A Russell
AR
Localio
5 Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
Anthony
A
Luberti
6 Department of Emergency Medicine, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
Joseph J
JJ
Zorc
2 Center for Pediatric Clinical Effectiveness , The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.|3 PolicyLab, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.|5 Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.|7 Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.
Alexander G
AG
Fiks
D001249:Asthma / Q000503:physiopathology*; D040421:Cell Phone; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D019114:Remote Consultation / Q000379:methods*; D012959:Socioeconomic Factors; D014218:Triage / Q000379:methods*; D035502:Trust; D019037:Urban Health Services / Q000458:organization & administration; D014743:Videotape Recording; D035862:Vulnerable Populations
asthma; emergency department; video triage