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| Title |
INTERNET-BASED MEDICAL RECORDS AND
COMMUNICATIONS COORDINATION FOR MANAGEMENT OF TECHNOLOGY-DEPENDENT CHILDREN |
| Author |
LA Bauman, M.D. |
| Affiliation |
Wake Forest University Baptist Medical Center,
Winston-Salem, N.C. 27157 |
| Introduction |
Recovery from critical pediatric illnesses may
be incomplete or prolonged, creating extraordinary burdens for parents and children. We
developed an Internet-based medical record Web site (1) to facilitate rapid transition to
a Home Intensive Care Unit (HICU), while attempting to improve parent satisfaction, and
while maintaining or improving patient outcome and lowering hospital costs. |
| Method |
Ten pediatric patients, ages 14 months to 19
years, were identified as being ventilator-dependent or medically fragile.
Internet-capable computers, provider accounts, and separate phone lines were provided to
the parents. Instructions on the use of the computer, the Internet, and the Internet
Medical Record were given to the parents, home health nurses, and all interested medical
practitioners involved in the child’s care. A satisfaction survey was given to
parents prior to the initiation of the Internet site, with a follow-up survey to the
parents receiving care after the Internet site’s launch. |
| Result |
To date, 104 patient-months of HICU support have
been provided through the Web site. Parental surveys reveal that communications are
improved between parents and tertiary physicians, but not with most primary care
physicians who are not yet Internet capable. Three critical events were identified during
the study period. |
| Conclusion |
Internet data exchange can be useful in the
management of chronically ill, technology-dependent children. Financial impact of the
program is undergoing a two-year analysis at our institution. Full implementation of the
program will include regular review of Internet information collected, third party
acceptance of Internet billing documentation, Internet-based visual and auditory
examination of the child at regular intervals, and regular psycho-social evaluation and
support of the family. Re-evaluation of the HICU program’s local and national success
is planned with completion of all the programs listed.1. http://homevent.wfubmc.edu |
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