A pilot study of telemedicine for post-operative urological care in children
Stephen Canon1, Annashia Shera2, Ashay Patel2
1Pediatric Urology Division, Arkansas Children's Hospital, Little Rock, Arkansas, USA University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA scanon@uams.edu.
Insights
Telemedicine effectively supports post-operative care for paediatric urology surgery patients, significantly reducing travel distance and time. This approach offers a viable alternative to on-site follow-ups, especially for remote patients.
Area of Science:
- Pediatric Urology
- Health Services Research
- Telemedicine
Background:
- Post-operative follow-up care is crucial for pediatric urology surgery patients.
- Geographic barriers can impede access to timely and convenient follow-up care.
- Telemedicine presents a potential solution to overcome these access challenges.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of telemedicine for post-operative follow-up in pediatric urology surgery.
- To compare patient outcomes and travel burden between telemedicine and on-site follow-up care.
- To identify factors influencing the adoption of telemedicine for post-operative care.
Main Methods:
- A retrospective study comparing 61 pediatric urology surgery patients over 12 months.
- Patients were divided into two groups: telemedicine follow-up (n=10) and on-site follow-up at Arkansas Children's Hospital (ACH) (n=51).
- Data collected included patient demographics, distance, travel time, and clinical outcomes.
Main Results:
- All telemedicine visits were completed successfully, with minor issues in video clarity in four cases.
- No post-operative surgical complications were observed in either group.
- Telemedicine patients experienced significant travel distance and time savings compared to on-site evaluations.
- Increased distance to ACH was associated with a higher likelihood of choosing telemedicine.
Conclusions:
- Telemedicine is a supportive and effective method for post-operative evaluation in pediatric urology surgery.
- The use of telemedicine can lead to substantial reductions in travel burden for patients and families.
- Telemedicine holds promise for improving access to care for geographically distant pediatric urology patients.
Abstract:
We conducted a retrospective study of paediatric urological surgery patients over a 12-month period. We compared patients followed up by telemedicine with those who had post-operative follow-up on site at the Arkansas Children's Hospital (ACH) in Little Rock. All pre-operative patients living in northwest Arkansas were given the opportunity to use telemedicine from a satellite clinic at Lowell, 328 km from the hospital. Of 61 patients, 10 chose telemedicine and 51 chose to be evaluated at the ACH clinic. All telemedicine visits were completed successfully, but in four cases, the video clarity of the telemedicine images was not sufficient for decision-making, and a digital photograph was sent by email to the physician at the ACH. There were no post-operative surgical complications in either patient group. In the telemedicine group, the median distance to the ACH was 330 km, and the median distance to the remote clinic was 35 km. In the on-site group, the median distance to the ACH was 293 km, which was significantly less (P=0.03). In the on-site group, the median travel time to the ACH was 174 min. If the telemedicine group had driven to the hospital, the median travel time would have been 192 min. Logistic regression showed that for every 37 km increase in distance to ACH, patients had a 111% increase in the odds of receiving telemedicine compared to receiving on-site care (OR=2.1, 95% CI: 1.0, 4.4). The pilot study supports the use of telemedicine for the post-operative evaluation of paediatric urology surgery patients and suggests that substantial travel distance and time savings can be made.
