Department of Pediatrics, University of Rochester, Rochester, New York 14642, USA.
Telemed J E Health. 2010 Jun;16(5):533-42. doi: 10.1089/tmj.2009.0138.
Acute illness challenges all families with young children. The Health-e-Access Telemedicine Network in Rochester, NY, has enabled >7,000 telemedicine visits since 2001 among children in childcare or elementary schools, predominantly from Rochester's inner city. Large reductions in illness-related absence and emergency department use among Health-e-Access participants have occurred.
The study was aimed to assess parent perception of telemedicine as a means to reduce burdens associated with childhood illness.
DESIGN/METHODS: A total of 800 parents were surveyed before (578) or after (318) a child had at least one Health-e-Access visit. Queries addressed access to healthcare, conflicts between work/school and child's care during illness, and concerns and likes about telemedicine. Perceptions were elicited through open-ended and direct queries.
Among all respondents, 16% had high-school education and 25% had a college education. Race/ethnicity of the respondents included black (43.6%), Hispanic (22.9%), white (30.0%), and other (3.5%). All identified a primary care practice as a source for well childcare. Most (58%) had given antipyretics to their child to avoid being called by childcare or elementary school staff about illness. Likert scale interview items addressing quality of care elicited low levels of worry or concern. Worry scores trended lower after experience. Among 532 comments about Health-e-Access elicited through open-ended probes, positive ones (likes) predominated (84.6%). Likes most commonly included convenience/time saved (33.6% of all comments), parent stayed at work (13.5%), drug delivered to child site (7.1%) or called ahead to pharmacy (4.9%), and confidence in care (2.3%). Negative responses (concerns) totaled 15.4% of comments and most commonly included reliability of diagnosis (2.6%), technical problems (1.3%), and preference for in-person care (0.8%).
Health-e-Access was well accepted by a substantial, diverse group of parents despite unfamiliarity with this approach to care. Convenience and convenience-related experience dominated perceptions. This model enables service beyond that mandated by payers and beyond that generally provided by medical practices.
急性疾病给有年幼子女的所有家庭带来挑战。自 2001 年以来，纽约罗切斯特的健康接入远程医疗网络已经为 7000 多名在日托或小学的儿童提供了远程医疗服务，这些儿童主要来自罗切斯特的市中心。健康接入参与者的与疾病相关的缺勤和急诊使用量大幅减少。
本研究旨在评估家长对远程医疗作为减轻儿童疾病相关负担的一种手段的看法。
设计/方法：共有 800 名家长在孩子至少进行一次健康接入访问之前（578 人）或之后（318 人）接受了调查。查询涉及获得医疗保健的途径、工作/学校与孩子患病期间的护理之间的冲突，以及对远程医疗的关注和喜好。通过开放式和直接查询来引出看法。
在所有受访者中，16%的人接受过高中教育，25%的人接受过大学教育。受访者的种族/族裔包括黑人（43.6%）、西班牙裔（22.9%）、白人（30.0%）和其他（3.5%）。所有人都将初级保健诊所作为儿童保健的主要来源。大多数（58%）人给孩子服用退烧药，以避免日托或小学工作人员因疾病而打电话。关于护理质量的李克特量表访谈项目引发的担忧或关注程度较低。在有过体验后，担忧得分呈下降趋势。在通过开放式探针引出的 532 条关于健康接入的评论中，积极的评论（喜欢）居多（占所有评论的 84.6%）。喜欢的内容最常见的包括方便/节省时间（33.6%的评论）、家长留在工作岗位上（13.5%）、药物送到儿童所在地（7.1%）或提前打电话到药店（4.9%），以及对护理的信心（2.3%）。负面回应（关注）占评论的 15.4%，最常见的包括诊断的可靠性（2.6%）、技术问题（1.3%）和对面对面护理的偏好（0.8%）。
尽管家长对这种医疗服务方式不熟悉，但健康接入仍被大量不同背景的家长所接受。方便和与方便相关的体验占据主导地位。这种模式使服务超出了支付者规定的范围，也超出了医疗实践通常提供的范围。
