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Telemedicine Takes the Lead in Child Abuse Detection

Health systems, social workers and advocacy groups are using connected care platforms to collaborate, giving front-line clinicians expert help in diagnosing children's cases.

By Eric Wicklund

- Healthcare providers are turning to telemedicine to tackle one of their most difficult tasks: identifying a victim of child abuse or neglect.

Many of these cases show up in hospital ERs, doctor’s offices or clinics where doctors and nurses are ill-equipped to make the proper diagnosis. But with a connected data management solution, providers can share images and other tests and communicate with trained specialists, ensuring the right diagnosis is made.

“We’ve saved lives, and we’ve saved families,” says Dr. Lori D. Frasier, division chief of child abuse pediatrics at Penn State Hershey Children’s Hospital, who uses the ProNet TeleCAM platform developed by XIFIN to consult with clinicians across the country.

“(This platform) has allowed us to bridge the gap between rural providers and national experts in the field by ensuring quality care for all children impacted by abuse,” added Kori Stephens, MPH, project director for the Midwest Regional Children’s Advocacy Center at Children’s Hospitals and Clinics of Minnesota, in a recent press release. “Many of our providers rely heavily on this system, and have expressed gratitude for the honest and important feedback they’ve received to improve their practice. Having an easy, secure, on-line platform makes this best practice much more accessible to those who would otherwise be at a loss.”

There are roughly 800 children’s advocacy centers across the country, supported by grants from the Department of Justice’s Office of Juvenile Justice and Delinquency Prevention and overseen by the National Children’s Alliance. The centers connect and collaborate with a wide range of agencies, including law enforcement, mental health, victim advocates, child protective services and healthcare providers.

“It is very gratifying to work with these leading children’s hospitals to provide collaborative, care management solutions focused on improving the diagnosis and treatment of abused and neglected pediatric patients,” said Patricia Goede, PhD, vice president of clinical informatics at XIFIN, in a recent release. “By connecting disparate providers across disciplines and geographic areas with both text-based and visual diagnostic content, we can vastly improve quality, time to diagnosis and outcomes for abused children.”

“There aren’t a lot of (clinicians) out there who can provide that expertise,” says Frasier, who served that role in Utah before moving to Pennsylvania more than two years ago, and noted that advocacy centers require an expert opinion before they’ll take any action. “You need someone who know what to look for.”

While identifying cases of child abuse and neglect is critical, Frasier says the telemedicine platform is also vital in preventing mistaken diagnoses – a bruise that really is just a bruise, or maybe a symptom of an underlying medical condition.

“The value is in the accuracy of the diagnosis,” she says. “Over-interpreting something can be a huge cost to children and families.”

Another health system using the ProNet TeleCAM platform, Intermountain Healthcare’s Center for Safe and Health Families in Salt Lake City, has reported a 28 percent reduction in time to diagnosis and more than 50 percent improvement in efficiency among nurses and nurse practitioners.

Frasier, whose department recently received a grant to expand the platform to other healthcare sites in the state, says it’s an invaluable tool for any hospital, clinic, doctor’s office, school nurse, retail clinic and other location where doctors and nurses treat children. It might also be incorporated into mobile devices for field workers, she said.

“This saves children and families,” she emphasized. 

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