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Telemedicine Reduces Pediatric Medication Errors in Rural EDs

A study from researchers at the University of California, Davis has shown that telemedicine consultations from pediatric specialists reduced the number of drug errors in eight rural emergency departments (EDs). Published in Pediatrics, the study is the latest in research from the university demonstrating that telemedicine consultations can improve quality of care in rural settings.

“We wanted to look at medication errors and see how telemedicine consultations impacted those rates compared to telephone consultations or no consultations at all,” says Madan Dharmar, MBBS, PhD, an assistant research professor in the Pediatric Telemedicine Program. “We know that having a specialist treat children lowers the risk of medication errors. However, no one had ever studied whether specialists could use telemedicine to have the same effect.”

Rural physicians face distinct disadvantages when providing critical care for severely ill or injured pediatric patients. In addition to lacking pediatric specialty training and experience treating children, emergency physicians in small rural hospitals often lack access to EMRs, computerized physician order entry, and 24-hour pharmacist coverage. Previous studies have confirmed that children are at greater risk when treated in rural EDs.

“In children, there’s a higher risk of medication errors because the drug doses are based on weight,” Dharmar says. “Because many of these physicians are not specialists in the treatment of children, there tends to be more errors.”

The study looked at the care provided to 234 patients. In 73 cases (31%), a pediatric critical care specialist conferred over a secure connection with an emergency physician, the patient, a nurse, and a parent or guardian (when available). In 85 cases (36%), the specialty consultations were conducted by telephone. In 76 cases (32%), the ED team received no specialist consult.

The results highlight how well these telemedicine consultations reduce medication errors. The error rate for the telemedicine group was 3.4% compared with 10.8% for telephone consultations and 12.5% when there were no consults. The most common errors were incorrect doses. Telemedicine patients had far fewer dosage errors. “Our results clearly show that using telemedicine to increase specialist presence lowers the risk of medication errors among seriously ill children,” Dharmar says.

In particular, the contrast between the telemedicine and telephone error rates seems to indicate that visual interaction is a key component to improving care.

The eight rural hospitals were provided telemedicine services, high-resolution monitors, and secure power supplies to facilitate the consultations. In addition, the University of California, Davis made pediatric critical care specialists available around-the-clock to provide these consults.

To determine the error rates, researchers looked at charts from the eight hospitals. Patients were older than one day and younger than 17 years and were chosen based on their high level of illness or injury. ED physicians made their own decisions on whether to take advantage of the telemedicine tools.

— Source: UC Davis Health System


Technology Inspires Optimism for Health Care
Most people are optimistic about technology innovations advancing health care, are willing to participate in virtual health care visits with their physician, and would use health sensors in their bodies and even their toilets, according to a study commissioned by Intel Corporation.

The Intel Healthcare Innovation Barometer, conducted across eight countries by Penn Schoen Berland, found the majority of people also believe that technology innovation holds the best promise for curing fatal diseases, more than increasing the number of physicians or additional funding for research.

“This survey indicates very high willingness of people to become part of the solution to the world’s health care problems with the aid of all sorts of technologies,” says Eric Dishman, an Intel fellow and the general manager of the company’s Health and Life Sciences Group. “Most people appear to embrace a future of health care that allows them to get care outside hospital walls, lets them anonymously share their information for better outcomes, and personalizes care all the way down to an individual’s specific genetic makeup.”

Intel’s research revealed that what people want most at the intersection of health care and technology is more personalized care based on their own behaviors and biology that provides the freedom to get health care wherever and whenever it’s convenient for them.

More than 70% of respondents were receptive to using toilet sensors, prescription bottle sensors, or swallowed monitors to collect ongoing and actionable personal health data. Sixty-six percent preferred a personalized health care regimen designed specifically for them based on their genetic profile or biology. Additionally, 53% said they would trust a test they personally administered as much as or more than if it came from a physician, and about 30% of people would trust themselves to perform their own ultrasound.

“Technologies such as high-performance computing and Big Data analytics have the power to change the face of health in this world, and most people seem to desire that,” Dishman says. “When given a choice between getting the same care as others who have their symptoms or getting care based on their own genetic profile, two in three respondents choose customized care.”

People indicated willingness to share their information to advance the field of medicine and lower costs for all. The survey revealed 84% of people globally would anonymously share their personal health information, such as lab results, if it could lower medication costs or overall cost to the health care system.

A higher percentage of people said they are more willing to share their health records (47%) than their phone records (38%) or banking information (30%) to aid innovation.

Fifty-seven percent of people believed traditional hospitals will be obsolete in the future. Technology innovation holds the promise of unburdening people from having to see a health care provider in person for many aspects of their health care management, liberating people from the conventional restraints of time and location.

Almost one-half of respondents (43%) globally would trust themselves to monitor their own blood pressure and other basic vitals. Seventy-two percent are willing to see a physician via videoconferencing for nonurgent appointments, and one-half would trust a diagnosis delivered via videoconferencing by their physician.

As remote health care technology and self-monitoring tools improve, people may embrace technologies that will allow them to connect with their caregivers in new ways, such as sensor technology that transmits health data in real time. Today’s technologies such as social networks and videoconferencing can help people embrace new behaviors.

— Source: Intel