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Using Video from Mobile Phones to Improve Pediatric Phone Triage in an Underserved Population
Brandi Freeman1, Stephanie Mayne2,3, A Russell Localio4
11 Department of Pediatrics, University of Colorado School of Medicine , Aurora, Colorado.
Insights
Mobile phone videos enhance pediatric asthma telephone triage. This approach is feasible and acceptable for underserved urban families, potentially improving care quality.
Area of Science:
- Digital Health
- Pediatric Emergency Medicine
- Telemedicine
Background:
- Mobile phones with video capabilities are common, yet their use in pediatric telephone triage is understudied.
- Few studies have explored using mobile phone videos to improve pediatric telephone triage, especially for underserved populations with asthma.
Purpose of the Study:
- To assess the feasibility, acceptability, and utility of using mobile phone videos to enhance telephone triage for pediatric asthma patients in an urban, underserved setting.
- To determine if video submissions improve the quality and reliability of triage assessments for children with asthma exacerbations.
Main Methods:
- Recruited pediatric patients with asthma exacerbations and their guardians from an urban emergency department.
- Collected concurrent in-person and mobile phone videos of children's respiratory exams.
- Assessed family acceptability via surveys and feasibility through successful video transmission rates.
- Clinicians reviewed videos to rate reassurance levels regarding asthma severity.
Main Results:
- 80% of parents found sending videos helpful; 68% trusted triage more with video review.
- 75% of families successfully transmitted videos.
- Clinicians found videos reassuring for 68% of children's asthma exacerbation severity.
Conclusions:
- Utilizing mobile phone videos for telephone triage is acceptable and feasible for urban, minority families.
- This video-based approach shows potential for enhancing the quality of pediatric telephone triage for asthma care.
Background:
Video-capable mobile phones are widely available, but few studies have evaluated their use in telephone triage for pediatric patients. We assessed the feasibility, acceptability, and utility of videos sent via mobile phones to enhance pediatric telephone triage for an underserved population with asthma.
Materials And Methods:
We recruited children who presented to an urban pediatric emergency department with an asthma exacerbation along with their parent/guardian. Parents and the research team each obtained a video of the child's respiratory exam, and the research team conducted a concurrent in-person rating of respiratory status. We measured the acceptability of families sending videos as part of telephone triage (survey) and the feasibility of this approach (rates of successful video transmission by parents to the research team). To estimate the utility of the video in appropriately triaging children, four clinicians reviewed each video and rated whether they found the video reassuring, neutral, or raising concerns.
Results:
Among 60 families (78% Medicaid, 85% Black), 80% of parents reported that sending a video would be helpful and 68% reported that a nurse's review of a video would increase their trust in the triage assessment. Most families (75%) successfully transmitted a video to the research team. All clinician raters found the video reassuring regarding the severity of the child's asthma exacerbation for 68% of children.
Conclusions:
Obtaining mobile phone videos for telephone triage is acceptable to families, feasible, and may help improve the quality of telephone triage in an urban, minority population.
