Peds Endorse Telemedicine With Caveats

Use of telemedicine for patient care is appropriate when integrated into the patient-centered medical home (PCMH) model, according to the first ever policy statement on telemedicine by the American Academy of Pediatrics.

James P. Marcin, MD, MPH and colleagues from the AAP Committee on Pediatric Workforce called for use of telemedicine services within the PCMH as a way to expand the quality and efficiencies of patient care and streamline its cost.

However, the committee discouraged "fragmented care" from third party providers, such as retail health clinics, because it disrupts care and undermines the PCMH model, they wrote inPediatrics.

The committee outlined the benefits of telemedicine, especially for children in rural areas and those needing care from a specialist. They cited studies that showed how telemedicine can be integrated into overall care management and can help increase the comprehensiveness of care delivered by improving communication between the patient and the entire care team.

Efficiency was another advantage for clinicians using telemedicine. So-called "eReferrals" -- where a primary care provider discusses a patient's condition with a specialist via telemedicine prior to an in-person referral, have been shown to increase primary care provider knowledge and actually decrease the amount of in-person referrals. The authors wrote that telemedicine programs have also led to more appropriate specialist referrals, as well as fewer diagnostic redundancies -- especially for children with special health needs.

Mary Ellen Rimsza, MD, chairperson of the AAP Committee on Pediatric Workforce, gave examples of how telemedicine is helping patients in her home state of Arizona, where telemedicine is being used to provide psychiatric care to children and adolescents in rural areas.

"Telemedicine can improve access to pediatric care, especially in pediatric medical and surgical specialties where there are significant shortages of these specialists," she toldMedPage Today. "Using telemedicine can help us make better use of specialists who are in short supply and thus provide care to more patients."