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Assessing patient safety in a pediatric telemedicine setting: a multi-methods study
Motti Haimi1,2,3,4, Shuli Brammli-Greenberg5, Orna Baron-Epel5
1Clalit Health Services, Digital Health Wing, Central Division, Tel Aviv, Israel. morx@netvision.net.il.
BMC Medical Informatics and Decision Making
|April 5, 2020
Summary
Pediatric telemedicine services demonstrate high patient safety, with appropriate diagnoses and reasonable decisions. Continuous improvement is recommended to further enhance accuracy and patient care in tele-triage settings.
Area of Science:
- Pediatric healthcare
- Telemedicine
- Patient safety
Background:
- Telemedicine and telephone triage may pose risks to patient safety if urgency is underestimated.
- Assessing the safety of pediatric telemedicine is crucial, focusing on diagnostic accuracy and decision-making reasonableness.
Purpose of the Study:
- To explore the patient safety level of a pediatric telemedicine service.
- To evaluate the appropriateness of medical diagnoses and reasonableness of decisions made by online physicians.
Main Methods:
- A retrospective multi-method study was conducted on a pediatric telemedicine service in Israel.
- 339 parent-physician consultations were reviewed for diagnostic appropriateness and decision reasonableness, comparing decisions to subsequent outcomes.
- 15 physicians were interviewed to explore their experiences and strategies for ensuring patient safety in tele-triage.
Main Results:
- High diagnosis appropriateness (98.5%) and decision reasonableness (92%) were observed.
- Low false-positive (2.65%) and false-negative (5.3%) rates, with good sensitivity (82.85%) and high specificity (96.15%).
- A strong correlation was found between online decisions and subsequent patient outcomes.
Conclusions:
- The examined pediatric tele-triage service demonstrates overall high patient safety.
- Further enhancements are needed to improve clinicians' diagnostic accuracy and treatment optimization in telemedicine settings to ensure patient safety.
