A S Strickler1, J Palma2, R Charris2, T Candia2, M Grez3, B González4, A King4, V Rivera5. 1. Escuela de Medicina, Departamento de Pediatría, Universidad San Sebastián, Puerto Montt, Chile, alexisstrickler@gmail.com. 2. Escuela de Medicina, Departamento de Pediatría, Universidad San Sebastián, Puerto Montt, Chile. 3. Hospital Dr. Eduardo Schütz Schroeder, Puerto Montt, Chile. 4. Unidad Inmunología, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile. 5. Escuela de Medicina, Departamento de Salud pública, Universidad San Sebastián, Puerto Montt, Chile.
Abstract
Children and adolescents with rheumatologic diseases require specialized and comprehensive care, but pediatric rheumatologists and immunologists are concentrated in hospitals with specific, high-cost and modern technology. Considering that some patients with juvenile idiopathic arthritis (JIA) live in rural, remote and limited accessibility areas, the use of Telemedicine (TM) can optimize diag nosis, follow-up and prognosis. OBJECTIVE: Reporting 10 years of experience of a mixed care model: face-to-face and distance, using basic TM; the institutional impact, advantages, disadvantages and acceptance informed by parents and patients. PATIENTS AND METHOD: Exploratory, descriptive, and re trospective study with qualitative component. After the authorization of a scientific-ethics committee of the Reloncaví Health Service and the application of informed consent, a review of medical records was carried out and a qualitative survey was applied to parents and children over 14 years of age with JIA, seen between 2005-2015 in the pediatric ambulatory rheumatology polyclinic of Puerto Montt Hospital. RESULTS: The were 27/35 participating patients with JIA attended by a trained pediatrician and assisted by distance (1,000 km) by an immunologist. The 8/35 patients did not answer by choice or change of address. The 70% of parents and patients accepted the model of care and 4% would pre fer sporadic care only by specialists for diagnosis and follow-up. The number of patients transferred annually decreased from 10 to 1. The advantages of the care model outweighed the disadvantages perceived by parents and JIA patients. CONCLUSION: The use of TM tools in JIA decreased transfers, improved follow-up and were considered advantageous by patients and their parents.
Children and adolescents with rheumatologic diseases require specialized and comprehensive care, but pediatric rheumatologists and immunologists are concentrated in hospitals with specific, high-cost and modern technology. Considering that some patients with juvenile idiopathic arthritis (JIA) live in rural, remote and limited accessibility areas, the use of Telemedicine (TM) can optimize diag nosis, follow-up and prognosis. OBJECTIVE: Reporting 10 years of experience of a mixed care model: face-to-face and distance, using basic TM; the institutional impact, advantages, disadvantages and acceptance informed by parents and patients. PATIENTS AND METHOD: Exploratory, descriptive, and re trospective study with qualitative component. After the authorization of a scientific-ethics committee of the Reloncaví Health Service and the application of informed consent, a review of medical records was carried out and a qualitative survey was applied to parents and children over 14 years of age with JIA, seen between 2005-2015 in the pediatric ambulatory rheumatology polyclinic of Puerto Montt Hospital. RESULTS: The were 27/35 participating patients with JIA attended by a trained pediatrician and assisted by distance (1,000 km) by an immunologist. The 8/35 patients did not answer by choice or change of address. The 70% of parents and patients accepted the model of care and 4% would pre fer sporadic care only by specialists for diagnosis and follow-up. The number of patients transferred annually decreased from 10 to 1. The advantages of the care model outweighed the disadvantages perceived by parents and JIA patients. CONCLUSION: The use of TM tools in JIA decreased transfers, improved follow-up and were considered advantageous by patients and their parents.
Authors: Yaffa R Rubinstein; Peter N Robinson; William A Gahl; Paul Avillach; Gareth Baynam; Helene Cederroth; Rebecca M Goodwin; Stephen C Groft; Mats G Hansson; Nomi L Harris; Vojtech Huser; Deborah Mascalzoni; Julie A McMurry; Matthew Might; Christoffer Nellaker; Barend Mons; Dina N Paltoo; Jonathan Pevsner; Manuel Posada; Alison P Rockett-Frase; Marco Roos; Tamar B Rubinstein; Domenica Taruscio; Esther van Enckevort; Melissa A Haendel Journal: JAMIA Open Date: 2020-09-11
Authors: María Celeste Savignano; Graciela Kondratiuk; María de Las Mercedes Martínez; Pablo Lechuga; Florencia Ugo; Mariel Della Corte; Alejandro Mato; Antonio Luna Journal: Curr Pediatr Rep Date: 2021-09-04