Telemedicine Presence in Pediatric Rheumatology
In pediatric rheumatology, patient access to certified providers is a troubling issue. The Arthritis Foundation estimates that approximately 300,000 children in the United States have juvenile idiopathic arthritis (JIA), but notes that there are fewer than 400 board-certified and practicing pediatric rheumatologists. There are presently 9 states (including Alaska, Idaho, Montana, New Hampshire, Oklahoma, South Dakota, Wyoming and West Virginia) that are without any full-time pediatric rheumatology providers. The American Academy of Pediatrics Division of Workforce and Medical Education Policy notes that most pediatric subspecialists are working in urban areas, at academic centers, with median wait times that may exceed 2 weeks for some specialties.
In pediatric rheumatology, this means that patients are traveling an average of 92 km (57 miles) to see their provider, compared with 40 km (25 miles) for patients followed in other pediatric subspecialties, and up to a quarter of adult rheumatologists care for pediatric patients with rheumatologic needs. This finding represents a considerable gap in access because most pediatric rheumatic diseases are chronic cyclic conditions. With respect to patient adoption of telemedicine, another study in pediatric rheumatology reported that, even though 28% of clinic patients traveled greater than 3 hours to see their pediatric rheumatology providers, most (95%) patients reported preference for in-person clinical visits rather than telemedicine visits. However, patient familiarity with telemedicine as a clinical tool did increase the preference for telemedicine visits. Before telemedicine practices can be adopted as a routine part of pediatric rheumatology care, providers and patients need to clearly understand its strengths and limitations as a tool for health care. For providers, this includes research that results in standardization of telemedicine practices, including (1) specification of patients appropriate for telemedicine follow-up, and (2) clinical guidelines for conducting appropriate and complete video examinations. For patients and their families, this may include education around telemedicine and planning for incorporating telemedicine as part of their routine chronic disease management.
Journal of Pediatric Care aims to distribute information on all scientific ground and social aspects related to pediatric issues and neonatal care. The journal of Pediatric Care will consider articles in the form of a research article, review article, short communications, case studies etc. bearing novel and valuable information for publication. The broader scope of the journal will consider submissions in the following areas: pediatric medicine, neonatal care, medicinal aspect of behavior development, care in neonatal intensive care unit, social care of infants and children and their impact on the behaviour etc.
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