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Catch That Bug!

August 31, 2005 By

As a single mother of three, Ericka Haines has dealt with her share of illnesses interrupting her work and school schedule. Haines remembers being pulled from class at a local community college in New York because her daughter, then 5 years old, was sick with strep throat and needed a visit to the doctor.

With public transportation as her means of travel, Haines said being called to pick up a sick child included frustrating hours of traveling and waiting.

Some say this is simply a fact of life for parents. Others insist it doesn't have to be that way.

Five child-care centers in Rochester, N.Y., participated in a two-year program, called Health-e-Access, designed to gather statistics on how virtual doctors' visits can help minimize young children's absences due to illness by catching and treating communicable illnesses quickly.

Health-e-Access also provides relief to parents whose children are sick but may not be contagious and could remain at the child-care center until the time they're usually picked up.

Before telemedicine, a child with an ear infection would have been sent home to seek medical attention, requiring a parent to leave work. Now telemedicine can quickly assess and diagnose the problem without parents setting foot out of the office.

As a result of the child-care centers' success with telemedicine, schools in the Rochester City School District are signing up for Health-e-Access.

Get With the Program

Health-e-Access originated in May 2001 at the University of Rochester's Strong Memorial Hospital through the efforts of pediatrician Dr. Kenneth McConnochie and his colleagues.

In the beginning, five day-care programs participated in the test study from January 2001 to June 2003. The program is now in the middle of a major expansion, adding two urban child-care centers, nine elementary schools and four suburban child-care centers.

The expansion also includes new doctors -- a dozen pediatric primary care physician groups have agreed to provide telemedicine services for their patients.

"Expansion into Rochester-area elementary schools is under way, but we are still in the training and technology rollout stage there," said McConnochie.

When the school district first considered the benefits of telemedicine in schools, two senior administrative leaders and a school board member went to the Carlson Downtown YMCA Children's Center to see the program in action.

"They wanted to see how it worked and understand how it could be used to address health problems in schoolchildren," McConnochie said.

Distance Diagnostics

The primary equipment for telehealth assistants includes a camera with specialized attachments for ear, throat and skin examination, and an electronic stethoscope to capture sounds from the heart and lungs. With these tools, a telehealth assistant captures fixed images, video clips and audio files to send to a participating pediatrician before a telemedicine visit is scheduled to occur.

The assistant does not need training in health care, said McConnochie, but needs to complete approximately 40 hours of training from Health-e-Access on using the equipment. The assistant uses symptom-driven protocol and electronic forms to paint a picture for the doctor prior to the visit, including the child's medical history.

During a visit, the pediatrician, assistant and child interact through video conference over a high-speed Internet connection. The software is supplied by Tel-e-Atrics Inc., which specializes in software and consultation services supporting telemedicine.

In some cases, a visit isn't even necessary. A common skin rash, such as impetigo or ringworm, need only be diagnosed by a clear image sent to the pediatrician by the telehealth assistant.

Private to Public

Telemedicine is not a new technology. The Center for Telemedicine and Telehealth at the University of Kansas Medical Center performed a pioneer rollout, called the TeleKidcare program, in elementary schools

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