TY  - CHAP
M1  - Book, Section
TI  -  Telehealth in Children with Special Needs
A1  - Webster, Kathleen A.
A2  - Rheuban, Karen Schulder
A2  - Krupinski, Elizabeth A.
PY  - 1
T2  - Understanding Telehealth
AB  - Isabella  was  born  prematurely,  with  congenital  heart  disease  and  hypoplastic  lungs.  She  underwent  several  surgeries,  including  a  tracheostomy  and  feeding  tube  placement.  After  many  months  in  the  hospital  she  was  able  to  be  discharged  home  on  a  home  ventilator.  Her  care  team  includes  a  pulmonologist,  cardiologist,  gastroenterologist,  and  the  complex  care  team.  In  the  year  since  her  discharge,  she  has  done  well  and  now  only  requires  a  ventilator  at  night.  During  that  year,  however,  she  developed  respiratory  viral  infections.  Each  illness  required  a  trip  to  the  local  hospital,  a  long  wait,  and  an  exam  by  an  unfamiliar  provider  who  then  transferred  her  by  ambulance  to  the  more  distant  children's  hospital  where  her  care  team  was  located.  Twice  she  was  able  to  be  sent  home,  and  three  times  she  was  admitted  to  the  intensive  care  unit  for  a  longer  hospital  stay.  Her  mother  was  frustrated  with  the  time  and  expense  of  these  visits.  She  wanted  to  be  able  to  keep  her  at  home,  but  agreed  that  the  team  needed  to  be  able  to  see  Isabella  frequently  during  her  illness  in  order  to  adjust  her  support.  A  new  telemedicine  program  was  implemented,  and  Isabella's  mother  was  given  a  tablet  computer  and  a  handheld  device  that  allowed  her  to  connect  to  the  complex  care  team.  When  Isabella  developed  a  slight  fever  and  increased  respiratory  secretions,  her  mother  called  the  care  team.  Her  physician  was  able  to  connect  by  video  and  guide  the  mother  through  a  physical  exam  with  a  stethoscope  and  skin  camera.  Isabella  was  placed  on  her  home  ventilator  for  4  days.  Her  physician  and  respiratory  therapist  connected  with  her  every  day  to  check  in  and  repeat  her  exam.  Isabella  was  able  to  remain  at  home,  and  her  mother  was  very  relieved  to  have  the  support  of  a  team  that  knew  her  well.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1157312217
ER  -