Originally published on The Inpathy Bulletin

A recent study on the effectiveness and safety of telemedicine services for children found that telemedicine is a valuable tool for treating both children with special health care needs and children in regular childcare and school.

Although children with special health care needs make up only 16% of the population of Americans under 18, they account for about 50% of all child health care spending. “Special Health Care Needs” is an umbrella term that covers a broad range of children and youth with chronic health conditions and disabilities and have an increased risk for chronic physical, developmental, behavioral or emotional conditions. According to the 2009/2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), more than one in five families (23%) has at least one child with special health care needs.Some of the more common conditions include

  • autism
  • cerebral palsy
  • developmental delay
  • intellectual disabilities, depression
  • learning disabilities
  • epilepsy

Due to the well-cited shortage of child and adolescent health care providers, including those within behavioral health, many children and their families face significant barriers in receiving appropriate care. According to the 2011-2012 National Survey of Children’s Health, many families of CSHCN find that insurance is not adequate (29%), care coordination is ineffective (43.6%), and referrals are difficult (24.5%).

Those challenges make it difficult for the healthcare facilities serving those families to offer adequate care options.

The study’s original focus was on that of a program called Health-e-Access and it’s effectiveness in regular childcare and schools in the Rochester, NY area. Efficiency and acceptability to parents of children with acute illness had already been well established by previous studies including over 14,000 telemedicine visits since May, 2011. A few highlights from the study include:

  • Among children attending inner-city childcare centers with telemedicine availability, absence due to illness dropped by 63%
  • 97% of visits initiated at elementary school and childcare sites were managed completely through the telemedicine platform. The other 3% led to referrals for higher-level care
  • Children with telemedicine access made 22% fewer emergency department visits than closely matched counterparts

Researchers considered the positive trend among results of telemedicine services for schoolchildren, and proposed extending the study to include services for children with special health care needs.

The findings supported the use of telemedicine in addressing ongoing care needs for children with special health care needs in rural communities. The completion rate for telemedicine evaluations with special needs children was even slightly higher at 98.1% than that of typical schoolchildren. When researchers examined the reasons for failure to complete the visits, their findings suggested that non-completion would occur even less frequently if parents and health care providers were more familiar with telemedicine as a care model.

The success of the telemedicine visits signifies that telemedicine consults are a great way to eliminate some of the most frustrating, and most common barriers to children and their families.

These often include needs for special transportation, special equipment, and attendants. Especially for developmentally challenged individuals, transitions to unfamiliar environments, such as traditional healthcare settings, may induce anxiety, fear, and disruptive behavior.