Children with asthma in rural areas receive quality care via telemedicine

For those in rural areas, telemedicine may be the best option for receiving care from a specialist who may be inaccessible due to travel time. But is this remote care equal in quality to what one would receive from physically seeing a physician? Researchers aimed to answer this question in a new study published in Annals of Allergy, Asthma and Immunology.

The study was conducted on children diagnosed with asthma and lived in rural areas, far away from the allergists that treat asthma. Being located hundreds of miles away from a specialist for their asthma care, they aren’t receiving quality, affordable cost. Telemedicine can improve those results by being administered at a local clinic for both the best quality and cost efficiency.

The study included children with asthma from two remote locations and gave them the choice of receiving care through a telemedicine session at a local clinic or an in-person appointment to the allergy clinic at Children's Mercy Hospital in Kansas City. The telemedicine visit was facilitated by a registered nurse or respiratory therapist who was on-site to operate the many tools included to take measurements.

Researchers included a Remote Presence Solution (RPS) equipped with a digital stethoscope, otoscope and high-resolution camera. The allergist on the other end of the telemedicine call was able to view and hear the patients in real-time and could pan a wide-angle camera for better visualization.

Both groups of children were evaluated before the study, after 30 days and at six months. Of the 169 children involved, 100 had an in-person appointment and 69 were seen via telemedicine. Thirty-four in-person and 40 telemedicine patients completed the three check-ins. The drop in check-ins and the in-person appointments showed that the long distance that needed to be traveled lead to more missed appointments while the drop in telemedicine check-ins was less apparent.

"We found that children seen by telemedicine using real-time video conferencing and digital exam equipment was just as effective as in-person visits," concluded allergist Jay Portnoy, MD, past ACAAI president and lead author of the study. "In addition, there were high levels of satisfaction by the kids and their parents, regarding the long-distance care."

"All of those seen—whether in the clinic or by telemedicine—showed an improvement in asthma control over the six months," said allergist Chitra Dinakar, MD, ACAAI Fellow and study author. "We were encouraged because sometimes those with the greatest need for an asthma specialist live in underserved areas such as rural or inner-city communities where allergists aren't always available. The study shows these kids can get effective care from a specialist, even if they don't happen to live close to where an allergist practices."