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RESEARCH PRODUCT

Telemedicine for pediatric surgical outpatient follow-up: A prospective, randomized single-center trial

Oliver J. MuenstererAlexandra ErtlJan GoedekeStephan RohlederDaniela Zöller

subject

AdultMaleTelemedicinemedicine.medical_specialtyAdolescentAftercarePilot ProjectsTelehealthSingle Centerlaw.invention03 medical and health sciences0302 clinical medicineRandomized controlled triallaw030225 pediatricsInterimOutpatientsPediatric surgeryHumansOutpatient clinicMedicineProspective StudiesChildQuality of Health Carebusiness.industryHealth Care CostsGeneral MedicineEvidence-based medicineMiddle AgedTelemedicineCaregiversPatient Satisfaction030220 oncology & carcinogenesisPediatrics Perinatology and Child HealthPhysical therapyFeasibility StudiesFemaleSurgerybusiness

description

Telemedicine is gaining popularity for a variety of indications. We performed a randomized controlled trial comparing telemedical versus conventional clinic follow-up in terms of feasibility and quality.Patients discharged from pediatric surgery were randomized to telemedical or onsite follow-up. In the telemedical group, video telephony was used to obtain interim history and physical findings. Onsite patients were personally seen in the outpatient clinic. Caregivers completed a postvisit survey on satisfaction and efficiency. Providers scored data transmission quality and clinical interpretability.From March 2015 until January 2017, 224 patients were randomized equally to the study groups. Telemedicine was highly accepted by caregivers, and data transmission quality was sufficient for comprehensive follow-up. No important clinical findings were missed. Quality of interaction scored higher in the telemedical versus the onsite group (77.8% vs. 48%, p  0.001) as did caregiver satisfaction (5.4 vs. 5.1, p  0.03). Travel investment, time required, loss of earnings, and days off from work/school were all significantly lower in the telemedical group (p  0.001).Telemedical posthospitalization follow-up in pediatric surgery provides a cost-effective, time-saving alternative for patients and caregivers that is well received and accepted. The quality of clinical data transmission is sufficient to provide safe care and uncompromised clinical judgment.Prospective and randomized controlled study.Level 1b.

https://doi.org/10.1016/j.jpedsurg.2018.10.014