Delivering tertiary tuberculosis care virtually

Area of Science:

• Pediatric infectious diseases
• Rare disease management
• Telemedicine in healthcare

Background:

• Children with rare diseases, such as tuberculosis (TB), often require specialized care that may involve significant travel.
• Access to multidisciplinary expertise is crucial for accurate diagnosis and effective management of rare pediatric conditions.

Purpose of the Study:

• To evaluate the effectiveness of a virtual multidisciplinary team (MDT) review panel in improving care for children with rare diseases.
• To assess if virtual MDT reviews can reduce patient travel without negatively impacting clinical outcomes.

Main Methods:

• A retrospective review of pediatric patients discussed in a virtual MDT panel was conducted.
• Data from Public Health England was analyzed for pre-intervention and post-intervention comparisons.
• The study included children under 16 years with suspected TB infection or disease across Paediatric departments in North West England.

Main Results:

• 45% of children received care closer to home, reducing the need for travel.
• The median time from presentation to treatment decreased by 28% (from 18 to 13 days).
• There was a 21% increase in children diagnosed before symptom onset, and 5 cases of misdiagnosed latent TB infection were corrected.

Conclusions:

• Virtual MDT reviews, as part of a clinical network, can enhance treatment for children with rare diseases.
• This model of care facilitates improved outcomes and supports 'care closer to home' initiatives.
• Telemedicine-based specialist consultations are effective in managing complex pediatric cases remotely.