Langkamp Diane L, McManus Mark D, Blakemore Susan D
1 Department of Pediatrics, Akron Children's Hospital , Akron, Ohio.
Telemed J E Health. 2015 Feb;21(2):110-4. doi: 10.1089/tmj.2013.0379. Epub 2014 Dec 29.
The literature on the use of telemedicine for children with developmental disabilities (DD) is limited and mostly describes telemedicine being used to link patients with distant subspecialty multidisciplinary care. Parents generally have reported satisfaction with such care and have perceived it to be equally effective as in-person care. Here we report on the use of school-based asynchronous telemedicine to connect children with DD with primary care providers.
We developed Tele-Health-Kids, a school-based program using asynchronous telemedicine to connect children with DD with their primary care physician for the care of minor illnesses. We surveyed parents at enrollment and after the child's first telemedicine visit to assess satisfaction. We describe 4 cases that illustrate benefits, particularly for children with DD and challenging behaviors, suggesting that asynchronous telemedicine may actually be superior to traditional in-office visits in some circumstances.
Most parents expressed a high level of satisfaction with the program. Benefits identified include decreased stress to the child and the parents as well as increasing the likelihood of a successful medical examination due to greater cooperation by the child. Visits using asynchronous or "store and forward" telemedicine technology may be superior in some situations by allowing the visit to be performed at a pace that can be adjusted to the needs of the child with DD.
More research in the use of asynchronous telemedicine for children and youth with DD, particularly for children with DD and challenging behaviors, is needed.
关于将远程医疗应用于发育障碍（DD）儿童的文献有限，且大多描述的是远程医疗用于将患者与远程专科多学科护理相连接。家长们普遍报告对这种护理感到满意，并认为其与面对面护理同样有效。在此，我们报告基于学校的异步远程医疗在将发育障碍儿童与初级保健提供者相连接方面的应用情况。
我们开发了“远程健康儿童”项目，这是一个基于学校的项目，利用异步远程医疗将发育障碍儿童与其初级保健医生相连接，以处理小病。我们在登记时以及孩子首次进行远程医疗就诊后对家长进行了调查，以评估满意度。我们描述了4个案例，这些案例说明了该项目的益处，特别是对患有发育障碍和具有挑战性的行为的儿童，这表明在某些情况下，异步远程医疗实际上可能优于传统的门诊就诊。
大多数家长对该项目表示高度满意。所确定的益处包括减轻孩子和家长的压力，以及由于孩子更好的配合而增加成功进行医学检查的可能性。使用异步或“存储转发”远程医疗技术进行的就诊在某些情况下可能更具优势，因为可以按照适应发育障碍儿童需求的节奏进行就诊。
需要对将异步远程医疗用于患有发育障碍的儿童和青少年，特别是患有发育障碍和具有挑战性的行为的儿童进行更多研究。
