Utilizing Telehealth for Education and Support of Rural Emergency Providers

Abstract

Session J presented Saturday, September 29, 11:30 am-12:30 pm Purpose: New Mexico is a rural state and access to pediatric specific care can require travel over long distances. The providers in rural areas do not utilize their pediatric skills and knowledge often and can lack confidence in the decisions needed to provide care. Design: The CRVPedED Telehealth Network was developed to provide clinical support and education to rural emergency providers in the care of the acutely ill or injured pediatric patient. Via the telehealth network, synchronous clinical support is offered on a case-by-case basis with peer discussion, and patient examination and family interaction Ongoing co-management of patients is also offered. Additionally, to increase knowledge and confidence in pediatric specific care education is offered via the telehealth network with structured, scheduled presentations and by attending originating site staff meetings virtually. Pre and post tests and confidence surveys are administered to evaluate knowledge acquisition and change in provider confidence level in caring for pediatric patients. Setting: This is a Level 1 Trauma center and we receive referrals from multiple rural facilities throughout New Mexico and bordering states. This project provided in person consults with rural facilities to co-manage patients and reduce the number of transports to tertiary facilities. Those that required transfer were stabilized with the co-management. Educational opportunities were offered to keep staff child ready, improving outcomes of a vulnerable population in rural facilities. Participants/Subjects: Pediatric patients in Rural communities. Hospitals were approached to participate and provided with technology to utilize for co-management of pediatric patients. Methods: Currently 11 facilities participate. We studied reduction in number of transports in correlation to number of consults. Education was offered to facilities regarding pediatric nursing care in an emergency department setting. Results/Outcomes: Thus far, 33 clinical consults have been completed avoiding 27 patient transfers. This resulted in 9000 patient miles and $1.1M health care dollars saved. We have conducted greater than 60 education interactions over the network. The improvement in confidence of healthcare providers is demonstrated by the comparison of pre and post survey following education opportunity. Implications: Telehealth can provide healthcare to rural areas offering care to a vulnerable population with specialized needs. The use of technology to reduce healthcare costs while providing needed care is the way of the future. Reduction in transport costs and dangers will provide age specific care within the communities.