PMID- 29394155
OWN - NLM
STAT- MEDLINE
DCOM- 20190725
LR  - 20190725
IS  - 1556-3669 (Electronic)
IS  - 1530-5627 (Linking)
VI  - 24
IP  - 11
DP  - 2018 Nov
TI  - Remote Presence Robotic Technology Reduces Need for Pediatric Interfacility 
      Transportation from an Isolated Northern Community.
PG  - 927-933
LID - 10.1089/tmj.2017.0211 [doi]
AB  - BACKGROUND: Providing acutely ill children in isolated communities access to 
      specialized care is challenging. This study aimed to evaluate remote presence 
      robotic technology (RPRT) for enhancing pediatric remote assessments, expediting 
      initiation of treatment, refining triaging, and reducing the need for transport. 
      METHODS: We conducted a pilot prospective observational study at a primary/urgent 
      care clinic in an isolated northern community. Participants (n = 38) were acutely 
      ill children <17 years presenting to the clinic, whom local healthcare 
      professionals had considered for interfacility transportation (IFT). Participants 
      were assessed and managed by a tertiary center pediatric intensivist through a 
      remote presence robot. The intensivist triaged participants to either remain at 
      the clinic or be transported to regional/tertiary care. Controls from a 
      pre-existing local transport database were matched using propensity scoring. The 
      primary outcome was the number of IFTs among participants versus controls. 
      RESULTS: Fourteen of 38 (37%) participants required transport, whereas all 
      controls were transported (p < 0.0001). Six of 14 (43%) transported participants 
      were triaged to a nearby regional hospital, while no controls were regionalized 
      (p = 0.0001). All participants who remained at the clinic stayed <24 h, and were 
      matched to controls who stayed 4.9 days in tertiary care (p < 0.001). There was 
      no statistically significant difference in hospital length of stay between 
      transported participants and controls (6.0 vs. 5.7 days). CONCLUSIONS: RPRT 
      reduced the need for specialized pediatric IFT, while enabling regionalization 
      when appropriate. This study may have implications for the broader implementation 
      of RPRT, while reducing costs to the healthcare system.
FAU - Holt, Tanya
AU  - Holt T
AD  - 1 Division of Critical Care, Department of Pediatrics, College of Medicine, 
      University of Saskatchewan , Saskatoon, Canada .
FAU - Sari, Nazmi
AU  - Sari N
AD  - 2 Department of Economics, College of Arts and Science, University of 
      Saskatchewan , Saskatoon, Canada .
FAU - Hansen, Gregory
AU  - Hansen G
AD  - 1 Division of Critical Care, Department of Pediatrics, College of Medicine, 
      University of Saskatchewan , Saskatoon, Canada .
FAU - Bradshaw, Matthew
AU  - Bradshaw M
AD  - 1 Division of Critical Care, Department of Pediatrics, College of Medicine, 
      University of Saskatchewan , Saskatoon, Canada .
FAU - Prodanuk, Michael
AU  - Prodanuk M
AD  - 3 Department of Pediatrics, College of Medicine, University of Saskatchewan , 
      Saskatoon, Canada .
FAU - McKinney, Veronica
AU  - McKinney V
AD  - 4 Northern Medical Services, Department of Family Medicine, College of Medicine, 
      University of Saskatchewan , Saskatoon, Canada .
FAU - Johnson, Rachel
AU  - Johnson R
AD  - 4 Northern Medical Services, Department of Family Medicine, College of Medicine, 
      University of Saskatchewan , Saskatoon, Canada .
FAU - Mendez, Ivar
AU  - Mendez I
AD  - 5 Department of Surgery, College of Medicine, University of Saskatchewan , 
      Saskatoon, Canada .
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20180202
PL  - United States
TA  - Telemed J E Health
JT  - Telemedicine journal and e-health : the official journal of the American 
      Telemedicine Association
JID - 100959949
MH  - Child, Preschool
MH  - Critical Illness
MH  - Female
MH  - Humans
MH  - Male
MH  - *Pediatrics
MH  - Pilot Projects
MH  - Propensity Score
MH  - Prospective Studies
MH  - *Robotic Surgical Procedures
MH  - *Rural Population
MH  - *Transportation of Patients/statistics & numerical data
MH  - Triage
OTO - NOTNLM
OT  - critical illness
OT  - pediatrics
OT  - telemedicine
OT  - transportation of patients
OT  - triage
EDAT- 2018/02/03 06:00
MHDA- 2019/07/26 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2019/07/26 06:00 [medline]
PHST- 2018/02/03 06:00 [entrez]
AID - 10.1089/tmj.2017.0211 [doi]
PST - ppublish
SO  - Telemed J E Health. 2018 Nov;24(11):927-933. doi: 10.1089/tmj.2017.0211. Epub 
      2018 Feb 2.