Pediatric Telemedicine can solve the difficulty community hospitals are facing recruiting and retaining pediatric physicians. And with the rising number of children with chronic health problems, the shortage these hospitals face today is expected to intensify in upcoming years.
Eagle’s TeleHospitalist Dr. Rebecca Jentzen is a new mom who believes in the value of TelePediatrics. “Kids are so adaptable, they might really like a ‘robot doctor,’” she says. “My adult patients really think it’s cool so I think kids would, too. It’s a great way to engage them and make the doctor visit a little more special that way.”
Witnessing the Decline in Pediatricians
On the local level, we see the lack of physicians reveal itself in multiple ways — the retirement of a physician who has served a small community for decades, or a local hospitalist who refuses to cover weekends or a rural hospital that’s filled the void with costly locum tenens physicians.
Locum tenens is great for short-term staffing solutions but was never intended as a long-term answer to any hospital’s staffing problems.
Why This Lack of Pediatricians?
To some degree, this shortage is linked with lifestyle. Many physicians prefer an urban environment and don’t last long in a rural community. While the hospital may have a pediatric hospitalist, a family medicine specialist, or a medical pediatric hospitalist who can provide daytime care for pediatric patients, but there’s often no vacation or weekend relief — so they are at high risk for burnout. If a nurse assistant is trained in pediatric care, they need a pediatric specialist who will work with them.
Without sufficient physician coverage, the result is much longer wait times — and transfers to tertiary hospitals — reducing the hospitals’ ability to provide timely, appropriate care for the families and children they serve.
There’s also a larger problem at work — an overall shortage in physicians throughout the country. Pediatrics has been especially hard-hit. In a nationwide survey by the Children’s Hospital Association, children’s hospitals were asked to name areas where pediatric specialist vacancies persisted for over a year.
Pediatric Neurology, Pain Management, Cardiovascular, and Otolaryngology were among the pediatric specialties with top highest wait times. The average wait time to see an Otolaryngologist is 2.3 weeks – one of the highest average wait times of surgical specialties.
Since 2014 there has been a steady decline in Otolaryngology applications of medical students across the country. Traditionally, otolaryngology has been a much sought-after specialty. In 2014, however, the number of otolaryngology applications to medical residencies began to drop. In 2017, the number fell below the number of available positions (305), and 14 spots went unfilled — an unprecedented situation.
Pediatricians and Otolaryngologists are an essential group of physicians caring for children and their families. Pediatric Cardiology and Neurology are also critical to at-risk children. Without these specialists, children won’t have access to the high-quality care they deserve.
Small Hospitals Welcome Tele-NICU
NICUs generate considerable revenue for hospitals. But in smaller hospitals, there often is no neonatologist. A high-risk infant typically requires transfer — often far from home. Tele-NICU provides an experienced neonatologist at a moment’s notice. Anywhere in the U.S., a hospital can have the expertise of a neonatologist “beam in”.
Meeting a Nationwide Need
We believe physician availability is one of healthcare’s biggest problems as we head into 2020. The use of telemedicine in healthcare can solve this problem.
Many hospitals are taking bold steps to deal with the reality of the physician shortage and are having strong success. For them, the physician shortage is no longer just a talking point, no longer an abstract concept that they are preparing for. These hospitals have taken the correct steps to shore up their hospital coverage with telemedicine.
The trend in digital technology has increasingly made all this possible. With the highest quality audio-visual capability, TelePediatric specialists can observe the child and all monitors in real time, providing guidance to local hospital staff.
Telemedicine is being adopted by hospital systems that service small communities, like one Eagle works with in Wisconsin. The system operates eight hospitals in north central Wisconsin, where there is acute lack of specialty physicians. The system’s leadership wanted to provide specialty services so these residents wouldn’t have to travel far for specialized care — and to avoid transferring so many patients to tertiary facilities to get the necessary care.
The Wisconsin system’s leaders saw the potential of telemedicine, and appointed a Medical Director of Virtual Care — a hospitalist at one facility whose responsibilities now include leading telemedicine programs that provide cardiology, infectious disease and stroke care “virtually” across the system. It’s been a huge success.
No longer are hospitals deploying only a TeleHospitalist or TeleNocturnist service. Instead, they are deploying multiple services via telemedicine. This way, they allow technology to do its job — maximizing the expertise of Specialists who can quickly adapt to each new patient’s situation, with a bedside manner that sets everyone at ease.
With a Director of Virtual Care position in place, these hospitals can renew the community’s respect and ensure proven technologies deliver real operational benefits. It’s a trend that is gaining momentum in this new era, when many restrictions have been lifted by the Centers for Medicare and Medicaid services.
Eagle’s TelePediatrics Program Serves All Communities
The beauty of Eagle’s TelePediatrics program is it’s 24/7/365 availability. Whenever and wherever a pediatric hospital patient needs a consult, the TelePediatrician is wheeled up (via the cart) within minutes. There’s seamless care, as the TelePediatrician can see — and talk to — the young patient (and family, if present).
The TelePediatrician can see all the monitors in real time, and the on-site staff will assist at every point. It’s as if the specialist is on-site, except that a child finds it ultra-cool the doctor is on the screen. The local providers learn exactly what next steps to follow, and very often can keep that child on-site, in their hometown hospital — close to home. No need for transfer 100 miles away, to the big hospital far from home.
The scariness factor is removed from a situation that’s already scary, as this may be the child’s first hospital experience. And what a great marketing tool for the local hospital, to provide this service for their community. At Eagle, we’ve heard it so often — “It’s the right thing to do.”