Advanced Pediatric Centre, Post-Graduate Institute of Medical Education & Research, Chandigarh, India.
Postgrad Med J. 2010 Dec;86(1022):688-91. doi: 10.1136/pgmj.2009.082735. Epub 2010 Sep 24.
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.
印度的儿童由于缺乏专业医疗保健而面临极高的死亡率和发病率，属于极高风险群体。远程医疗技术可以让异地专家为儿科患者提供远程医疗服务，这是解决印度次大陆专家短缺问题的极具潜力的方法。我们在印度北部的一家三级保健教学医院，通过对电子数据库进行为期 4 年的前瞻性分析，评估了远程医疗服务在儿科疾病诊断和管理中的应用。所覆盖的年龄组为新生儿至 15 岁的儿童。评估的结果包括：可行性、诊断可能性、管理、结果、转诊和每位患者的平均费用。结果如下：主要咨询涉及 5 岁以下儿童，其中新生儿占总咨询量的 5.5%。主要与系统相关的问题是：胃肠道、呼吸道、神经、感染和血液系统。建议转诊的比例为 14.3%。10%的儿童病情危急，无法安全转运。21.4%的患者进行了视频会议。这些咨询的反馈和后续工作很少（占总数的 12%）。所有咨询中每个孩子的总节省费用约为 1000 印度卢比（约合 22 美元），扣除远程医疗咨询费用。总之，印度的远程儿科医学仍处于起步阶段。在远程儿科医学服务在印度得到广泛接受之前，需要解决障碍和医疗法律问题。
