Adaption of Follow-Up Visits for Preterm and High-Risk Children for Video Consultations
Anne-Kathrin Dathe1,2,3, Sandra Greve1,2, Uta Teschler1,2
1Department of Paediatrics I, Neonatology, Paediatric Intensive Care and Paediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Insights
Video consultations can effectively identify developmental delays in children up to age six, offering a viable alternative to in-person visits when necessary. This approach maintains high follow-up rates and comparable resource use for early detection and intervention planning.
Area of Science:
- Pediatrics
- Telemedicine
- Developmental Psychology
Background:
- Structured follow-up care is crucial for early detection of developmental deficits in preterm and high-risk infants.
- Traditional in-person consultations present logistical challenges and may be inaccessible for some families.
- Telemedicine offers a potential solution to enhance accessibility and continuity of care.
Purpose of the Study:
- To adapt and evaluate the efficacy of video consultations for infant and child follow-up care.
- To compare video consultations with traditional in-person follow-up regarding developmental delay identification.
- To describe professionals' experiences and the challenges associated with implementing video consultations.
Main Methods:
- Descriptive analysis of adapted in-person follow-up protocols for video consultations.
- Comparison of video and in-person consultations, noting similarities, differences, challenges, and limitations.
- Survey of healthcare professionals' experiences with both consultation formats; analysis of 267 video consultations.
Main Results:
- Video consultations are feasible and necessary, requiring stable digital connections and secure platforms.
- Parent-guided testing is common for infants; adapted procedures exist for older children.
- Neurological exams are largely possible, but general pediatric exams are omitted; professionals found video consultations comparable to in-person visits for developmental delay detection up to age six.
Conclusions:
- Video consultation is a suitable alternative for follow-up care when in-person visits are not possible, enabling early identification of developmental delays.
- While some limitations exist (e.g., physical examination for older infants), therapies can still be recommended.
- Successful implementation requires appropriate technology and adapted assessment strategies.
Abstract:
Introduction: Structured and standardized follow-up care for preterm and high-risk infants enables an early detection of developmental deficits. The aim is to adapt the in-person follow-up to video consultation. Developmental delays can thus be identified at an early stage, independently of in-person contact. Methods: The adaptation of these follow-up to video consultation is presented descriptively, compared with the in-person consultation (similarities, differences, challenges, and limitations). Professionals's experiences with the adaption are described. Results: The experience of n = 267 video consultations for follow-up of children up to 6 years shows that an adaptation of the in-person consultation is necessary and possible. Prerequisite is a digital medium with a stable internet connection on both sides: the professional and the family, as well as a portal for video consultations with certified, encrypted data transmission. Among infants, testing is almost entirely parent guided. For older children, testing procedures have been adapted. A neurological examination is largely possible, while a general pediatric examination is omitted. A survey on professionals' (n = 7) experiences with video- and in-person consultations found that the rate of complete follow-up visits and the resources required for taking medical histories, personnel, and time remained constant for both approaches. All reported that the video consultation is generally suitable for identifying developmental delays in children up to an age of 6 years comparable with in-person consultations. One professional stated that the physical examination of children aged ≥1 year is impossible. Discussion: Video consultation is an alternative despite some limitations when an in-person consultation is impossible. Developmental delays can be identified, and therapies recommended.
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