WHAT’S THIS ALL ABOUT?
The comprehensive Tel-e-Atrics-Connect system and support services are designed to make health care for illness more readily available. Specifically, the system creates a telemedicine link between a patient (childcare centers, schools, group homes, etc) and the patient’s own healthcare team, so that sick individuals can see their doctor through a real time “virtual office visit” without leaving their environment.

One of the early successful implementations of the Tel-e-Atrics-Connect system has been in multiple daycare center and elementary schools in Rochester, NY. This program has allowed childcare centers and schools, and the regular doctors of the children in these programs to work together to integrate telemedicine into existing day-to-day health care practices. This telemedicine link provides families an effective alternative to deal with common illness in children, without the time disruptive need to physically transport them to medical offices, or an even more undesirable scenario, not obtaining timely treatment before the illness becomes serious.

WHAT IS TELEMEDICINE?
Telemedicine uses a video camera and other special medical cameras and instruments to send live images, pictures and sound recordings to a doctor and the healthcare team at their office. Doctors or nurse practitioners in an office, clinic, or hospital, working with a telehealth assistant at the patient’s location (school, day care center, group home, etc) can examine the patient much like they do in a traditional office visit. For example, instruments will allow the doctor or practitioner to examine ears and throat and listen to heart and lungs. The patient, the telehealth assistant and the doctor can all see and talk to one another during the examination using real-time video conferencing.

CAN TELEMEDICINE HELP?
Again, referring to the actual use of Tel-e-Atrics-Connect system and services in a broad based school and day care center implementation, there were numerous tangible benefits of telemedicine to the families and children who have participated in these programs. These included :

• Allowing a doctor or nurse practitioner to check the child to be sure it’s appropriate for the child to return to the daycare center after an absence due to illness.
• Allowing the child to actually stay in childcare or school despite illness because diagnosis and treatment was carried out quickly as result of a telemedicine visit.
• Allowing parents to miss less work time.
• Allowing parents to avoid an unplanned visit to a doctor’s office, after-hours clinic, or even the emergency department.
• Provide for a prescription to be waiting for parents at their pharmacy when they leave work, alternatively have it delivered to the childcare center or school to start immediate medication if appropriate after a telemedicine visit.
• Provide comprehensive records (including pictures) of an illness evaluation as part of the child’s permanent medical record residing with the physician.

HOW DOES TELEMEDICINE WORK?
In the daycare or school setting implementation, parents sign up and provide consent for participation in the telemedicine program at the time the Teleatrics equipment was installed. Telemedicine examinations, by a number of participating pediatric care providers and practices are available routinely every day at hours requested by childcare centers and schools. If a child is sick at the beginning of the day, parents at drop-off will be asked by staff to provide information describing the illness and they can actually stay if the parent desires a telemedicine evaluation during the day. If the child’s illness has become apparent during the school or careday, the telehealth assistant attempts to contact parents regarding the illness, and will arrange for the child’s physician or practitioner to examine the child via telemedicine.

After every telemedicine examination, parents receive written instructions with the physician’s diagnosis and recommendations for treatment and follow-up. All components of the evaluation, including pictures of key parts of the examination, such as an infected ear or recordings of heart/lung sounds, become part of the child’s permanent record maintained by the physician.

LIMITATIONS OF TELEMEDICINE
Of course, not every telemedicine evaluation will prevent a doctor’s office or emergency department visit. Situations will arise when laboratory tests, x-rays, or a hands-on physical examination is needed. Likewise, in a daycare or school setting, not every telemedicine evaluation will allow a sick child to remain in childcare or school. Sometimes a child will simply be too sick to stay because of the additional care needed.

EXPERIENCE TO-DATE IN AN EXPANDED/MULTI-LOCATION DAYCARE/SCHOOL PROGRAM

• Telemedicine visits have been available in selected Rochester, NY urban/suburban area daycare and school settings since May 2001.
• As of January 2006 over 3,500 visits have been completed (a majority in the past 12 months).
• 95% of the telehealth visits were completed without the need for an in-person visit.
• Overall, this program has demonstrated a 63% reduction in absence due to illness at participating childcare centers.
• Parents report saving an average of 6 hours of work time for each telemedicine visit.
•