Increasing Utilization of an In-Home Remote Exam Device in a Complex Care Center.

Area of Science:

• Pediatric complex care
• Health services research
• Quality improvement science

Background:

• Telehealth and remote exam devices offer benefits for children with medical complexity (CMC), enabling home-based care and reducing caregiver burden.
• Current utilization of remote exam devices during telehealth visits in complex care centers is low.
• The study addresses the need to enhance remote care capabilities for CMC.

Purpose of the Study:

• To increase the percentage of telehealth visits utilizing remote exam devices for CMC.
• To achieve a target of 50% utilization within a six-month period.
• To evaluate the effectiveness of quality improvement interventions.

Main Methods:

• A multidisciplinary quality improvement team implemented Plan-Do-Study-Act cycles in a pediatric complex care center.
• Key interventions included improving device access, patient identification, connection ease, provider coaching, and user education.
• Data collection focused on the percentage of telehealth visits using remote devices and device distribution numbers.

Main Results:

• The median percentage of telehealth visits using remote exam devices increased from 0% to 43% during the intervention period.
• Device utilization showed non-special cause variation in the four months following the active intervention.
• Increasing the distribution of devices emerged as the most effective intervention strategy.

Conclusions:

• Quality improvement methodologies successfully increased the use of in-home remote exam devices for CMC.
• The findings highlight the importance of targeted interventions, particularly device distribution, to optimize telehealth for complex pediatric populations.