Department of Nursing and Health Sciences, Université du Québec en Outaouais, C.P. 1250, Succursale Hull, Gatineau, Quebec, J8X 3X7, Canada; Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, 7101 Park Ave, Montreal, Québec, H3N1X9, Canada; Public Health Research Institute of the University of Montreal, 7101 Park Ave, Montreal, Québec, H3N1X9, Canada.
Division of Pediatric Critical Care, Department of Pediatrics, Sainte-Justine University Hospital, 3175 Chemin de la côte-Sainte-Catherine, Montreal, Québec, H3T1C5, Canada.
Int J Med Inform. 2019 Sep;129:219-225. doi: 10.1016/j.ijmedinf.2019.06.009. Epub 2019 Jun 17.
The aim of this study was to assess the feasibility of implementing a synchronous telemedicine platform in a pediatric intensive care unit (STEP-PICU).
A prospective mixed study was conducted. Two sources of data were mobilised: a survey with structured questionnaires and direct non-intrusive observation. The study site was the PICU of a university hospital. Users' perceptions of six aspects of the STEP-PICU were studied: telemedicine system quality, data quality, quality of technical support, use of the new system, overall satisfaction and system benefits.
During the 6-month experimentation period, use of the telemedicine platform was rather limited and fell short of the promoter's expectations.The mean scores for the six user perception dimensions were low, with no differences between the two groups of users. A Mann-Whitney test showed that being an off-site pediatric intensivist or on-site fellow did not make a statistically significant difference in responses on system quality (p = .518), data quality (p = 1.00), quality of technical support (p = 1.00), system use (p = .556), overall satisfaction (p = .482), or benefits (p = .365). The low use of the STEP-PICU was attributed to three root causes: human factors, the platform's functionalities, and technical problems.
The synchronous telemedicine service for PICU was feasible but would need good pre-implementation preparation to be truly helpful. Its usefulness during the night shift and holiday on-call periods was scored as low by the off-site pediatric intensivists and the on-site fellows. It would appear that such a service could be more beneficial for communications with other remote healthcare facilities, where there is a greater need for the expertise of a pediatric critical care intensivist.
本研究旨在评估在儿科重症监护病房（PICU）中实施同步远程医疗平台的可行性。
进行了一项前瞻性混合研究。动员了两种数据源：带有结构化问卷的调查和直接非侵入性观察。研究地点为一家大学医院的 PICU。研究了 STEP-PICU 的六个方面的用户感知：远程医疗系统质量、数据质量、技术支持质量、新系统的使用、总体满意度和系统效益。
在 6 个月的试验期间，远程医疗平台的使用相当有限，未能达到推广者的预期。六个用户感知维度的平均得分较低，两组用户之间没有差异。曼-惠特尼检验表明，作为远程儿科重症监护医师或现场研究员，在系统质量（p=0.518）、数据质量（p=1.00）、技术支持质量（p=1.00）、系统使用（p=0.556）、总体满意度（p=0.482）或效益（p=0.365）方面的反应没有统计学差异。STEP-PICU 使用量低归因于三个根本原因：人为因素、平台的功能和技术问题。
PICU 的同步远程医疗服务是可行的，但需要良好的实施前准备才能真正发挥作用。远程儿科重症监护医师和现场研究员对夜间和节假日值班期间的服务实用性评分较低。这种服务似乎对与其他远程医疗设施的沟通更有帮助，在这些设施中，儿科重症监护专家的专业知识需求更大。
