Rayquan is an 18 month old boy at one of the Rochester childcare centers served by the TeleAtrics system. His story started with a question after we finished a Telehealth visit for another child. The Certified Telehealth Assistant (CTA) wanted to know whether something more could be done about Rayquan's persistent cough. This question led to other questions, to a Telehealth visit with Rayquan, and then to a phone call from the Telehealth physician to Rayquan’s primary care pediatrician (who hadn’t heard about the problem). Every afternoon over the past 2 weeks, Rayquan was having fits of coughing, often protracted enough and severe enough to induce vomiting. Rayquan’s mom knew his cough responded well to his nebulized asthma “rescue” medicine, although she also knew these coughing fits started up again 4 to 6 hours after each dose. She was afraid to take time off from work to see if something more could be done, so she instructed the childcare staff, “It’s just his asthma, just keep giving him his asthma medicine, he’ll be fine.”

The outcome of the phone conversation was that the primary care pediatrician agreed with the Telehealth physician that an inhaled anti-inflammatory, preventive asthma medication was indicated. The medication was started, 2 days later the cough stopped, and the nebulized “rescue” medication was no longer needed. Everyone was delighted, especially mom. She had been struggling with the dilemma of whether his cough was so bad that she needed to risk her job to have him seen. Also, she was pretty tired of getting up in the middle of the night to give him his “rescue” medicine.

How important is this? One indication came last week from the grandmother of 3 children I care for in the Pediatric Practice at Strong. I hadn’t seen her in a while, and she told me how excited she was about Health-e-Access. Friends of hers who use Health-e-Access Telehealth serviced childcare centers say, “There’s no stopping us now.” In other words, now that the dreaded call from childcare – come pick up your child – is not nearly so common, they feel like they are going to be able to hold jobs and improve their economic situation. There are, of course, other difficult issues that inner city parents face. But telehealth is so important that prospects feel a whole lot better.

Kenneth McConnochie, MD, MPH
Rochester Health-e-Access Telehealth Network