Technology Supports Rural Children With Medical Complexities

Amber Hoffman, M.D., and Ingrid Larson, MBA, M.S.N., APRN, CPNP, lead the Beacon Program at Children's Mercy Kansas City, which is on the forefront of testing new care delivery models for rural children with complex medical conditions across western Missouri. "Our program streamlines health care for families of these children and their siblings," Hoffman says. "The goal is to simplify appointment scheduling and reduce patient visits and admissions." The program relies on the simplicity of telemedicine to provide support to physicians and children in rural communities through remote visits and a complete specialty team.

At the consult visit, the physician or nurse practitioner, dietitian, social worker and DME/home nursing coordinator consult with the patient in a video visit without the child visiting the main Children's Mercy campus. Equipment needs are minimal—the team accomplishes visits with a laptop computer and a pull-down screen in Hoffman's office. Team members then cycle through during the appointment.

During the initial telemedicine wellness visit, which can last from two to four hours, each team member assesses the child's needs and develops a comprehensive view of the patient. From there, the team prioritizes the patient's most pressing issues while making sure other areas of his or her care are being met. Once the team establishes a care plan, the plan and patient goals are added to the electronic medical record, and the primary care physician takes responsibility for enacting it. The family contacts the primary care physician for any care needs. The Beacon team serves as a resource for the primary care physician, who can call on the team to address specific issues or for short emergency visits.

Read more via Children's Hospital Association.