Feasibility of Post-hospitalization Telemedicine Video Visits for Children With Medical Complexity.

Abstract

Objectives

To evaluate feasibility and acceptability of post-hospitalization telemedicine video visits (TMVV) during hospital-to-home transitions for children with medical complexity (CMC); and explore associations with hospital utilization, caregiver self-efficacy (CSE), and family self-management (FSM).

Method

This non-randomized pilot study assigned CMC (n=28) to weekly TMVV for four weeks post-hospitalization; control CMC (n=20) received usual care without telemedicine. Feasibility was measured by time to connection and proportion of TMVV completed; acceptability was measured by parent-reported surveys. Pre/post-discharge changes in CSE, FSM, and hospital utilization were assessed.

Results

64 TMVV were completed; 82 % of patients completed 1 TMVV; 54 % completed four TMVV. Median time to TMVV connection was 1 minute (IQR=2.5). Parents reported high acceptability of TMVV (mean 6.42; 1 -7 scale). CSE and FSM pre/post-discharge were similar for both groups; utilization declined in both groups post-discharge.

Discussion

Post-hospitalization TMVV for CMC were feasible and acceptable during hospital-to-home transitions.

Department

Description

Provenance

Subjects

Humans, Aftercare, Hospitalization, Patient Discharge, Feasibility Studies, Pilot Projects, Telemedicine, Child

Citation

Published Version (Please cite this version)

10.1016/j.pedhc.2021.10.001

Publication Info

Ming, David Y, Tingxuan Li, Melissa H Ross, Jennifer Frush, Jingyi He, Benjamin A Goldstein, Valerie Jarrett, Natalie Krohl, et al. (2022). Feasibility of Post-hospitalization Telemedicine Video Visits for Children With Medical Complexity. Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners, 36(2). pp. e22–e35. 10.1016/j.pedhc.2021.10.001 Retrieved from https://hdl.handle.net/10161/29623.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Ming

David Yung Ming

Associate Professor of Pediatrics

I am a med-peds hospitalist and researcher with interests in improving systems of care of patients with complex health needs. My research focus areas include implementation science, population health sciences, community-engaged research, and digital health. My vision is to design, implement, evaluate, and scale programs and interventions that will simplify the delivery of complex care. By doing so, we can equitably improve the health outcomes that matter most to children and adults with complex health needs and their families.

Goldstein

Benjamin Alan Goldstein

Professor of Biostatistics & Bioinformatics

I study the meaningful use of Electronic Health Records data. My research interests sit at the intersection of biostatistics, biomedical informatics, machine learning and epidemiology. I collaborate with researchers both locally at Duke as well as nationally. I am interested in speaking with any students, methodologistis or collaborators interested in EHR data.

Please find more information at: https://sites.duke.edu/bgoldstein/

Docherty

Sharron Lee Docherty

Associate Professor in the School of Nursing

Dr. Docherty’s research is aimed at improving outcomes for children, adolescents, young adults and families undergoing treatment for life-limiting and chronic conditions. She studies how to improve care models, symptom management, and decision making from diagnosis through end of life.  She has methodological expertise in the use of qualitative, mixed-methods, trajectory science and visualization methodologies for complex data exploration, and intervention development and testing.


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