Telemedicine in pediatric primary care. Favorable experience in nurse-staffed inner-city clinic
N. Cunningham, C. Marshall and E. Glazer
Off-site pediatric consultation via bidirectional cable television (TV) was
instituted to provide backup for nurse practitioners treating sick and well
children in a small primary-care clinic. During a year of study of the
system, there were 2,161 clinic visits and 285 TV consultations. When both
TV and telephone consultation were available, TV was used for 10.8% of the
visits, and telephone was used for 9.6% of visits. Staff reactions, though
initially skeptical, were ultimately favorable. The system allowed
pediatric nurse practitioners to function without on-site physician
coverage 40% of the time. The main disadvantages were technical. Further
work is needed to assess the reliability and validity of TV consultation
and its acceptability in other settings.
