House calls for the 21st century

Through a new study capitalizing on videoconferencing, U researchers hope to remodel how health care is delivered.

Ask any parent: bringing a child to the doctor or clinic for an appointment can be costly, time-consuming and requires a lot of patience. 

But what if your child could receive face-to-face care from a nurse or doctor without leaving the house? This is where the concept of “telehealth” comes into play.

“Telehealth can amount to a 21st-century house call,” describes Stanley Finkelstein, Ph.D., a professor in the University of Minnesota’s Department of Laboratory Medicine and Pathology. “Today, videoconference technology allows a nurse or doctor to conduct a ‘virtual visit’ with the patient in the comfort of the patient’s home.”

Finkelstein, the Principal Investigator, along with School of Nursing faculty and co-Investigators Ann Garwick, Ph.D., R.N., and Wendy Looman, Ph.D., RN, CNP, recently received a $2.1 million National Institutes of Health (NIH) grant to evaluate how telehealth technology may help families of children with complex health care needs.

Children with acute health problems – illnesses with a rapid onset or short duration such as strep throat or an ear infection – may be in and out of a local clinic in one visit.

But Looman explained that for children with chronic or recurrent conditions, a quick visit to their provider is rarely the case. Families of children with chronic conditions often have to navigate complex care systems. Repeat visits to the hospital or clinic become a routine part of life.

It’s for these families that telehealth appears to have the most benefits, and it’s for these families that the University’s telehealth study is designed to provide the most benefit.

Expanding the role of telehealth in managing disease

As part of the U of M telehealth study, participants’ families are provided with a computer, web camera, videoconference software and basic instructions.

This is a randomized controlled study, with a control group receiving standard triage, and one intervention group receiving triage provided by an advanced practice nurse. The child participants and their families in a second intervention group conduct video-chat meetings with an appointed advanced nurse practitioner as needed. Each of the intervention families work continuously with the same advanced practice nurse throughout the course of the study.

“How many times have parents contacted their physician practice, hospital or clinic and spoken with a different nurse or care provider, each time needing to re-explain their child’s condition?” asks Looman. “Unfortunately, patient-assigned nurses are not the standard in today’s health system. We think as the nurse and families in our trial get to know each other over time, the nurse will become an expert on the child’s needs.”

“Having an advanced practice nurse in a dedicated care coordination role minimizes the amount of calls the family needs to make to coordinate care among multiple providers,” said Looman. “In addition, such a nurse has the ability to get to know the family over time, and we think that the end result will be that the nurse becomes an expert on the child’s needs.”

Advanced nurse practitioners have the ability to visually assess the child, diagnose issues, as well as recommend treatment, all via videoconference.

The researchers expect to see improved proactive and in-depth care planning.

“The combination of telehealth technology and a strong focus on families provides an unmatched level of coordinated care, in arguably the most convenient way possible,” Looman says. 

--- Sarah Hamman