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The simplest description of remote medicine or telemedicine is that medical service including prescriptions, consultations and video conferencing are done online. This is a big help in rural areas or underserved areas, where medical providers are stretched thinly. It has also proven to be a viable solution for ADHD cases where the medical provider or specialist are few, or far from the majority of patients.

Cases of ADHD Among Children

In this case, a Jacksonville, Florida, private pediatric practice is having success with a remote medicine platform for pediatric patients diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). The Rainbow Pediatric Center is composed of 7 health providers serving the areas of Jacksonville and Ponte Vedra. Due to its success, Rainbow Pediatric has been designated a Level 3 Patient-Centered Medical Home (PCMH) by the National Committee for Quality Assurance.

A survey by the National Survey of Children’s Health in 2016 showed that about 6.1 million or 9.4% of children between the ages of 2 and 17 have been diagnosed with ADHD. This was distributed as follows:

  • Children between the ages of 2 to 5, estimated to be 388,000 children
  • Between 6 to 11, about 2.4 million children
  • Between 12 and 17, about 3.3 million children

An earlier study by the NSCH covering children between the ages of 4 and 17 showed that there was in increase of 43% between 2003 and 2011. Among children with ADHD, about 62% were taking medication, and about 46% had received behavioral treatment during the past year.

Scheduling Problems

According to Rainbow Pediatric Center founder and CEO Prasanthi Reddy, M.D., frequent medical visits, along with the follow-up appointments are necessary for ADHD patients. In an article in Healthcare Informatics, Dr. Reddy underlined the importance of regular visits to the patient’s well being.

These visits will help monitor the ADHD syndrome and help to keep the diagnosis accurate. This will also ensure that other learning disabilities and mood problems associated with ADHD are properly identified. The children should comply with their treatments, but both patients and parents have a tendency to be forgetful

Parents are not often willing to pull out their children from school in order to attend sessions. Rescheduling the visits to after school hours resulted in a logjam of schedules where not enough children could be accommodated for a session.  Parents are willing to take their children to doctor visits every three months instead of every month and this is unfortunately not enough to make any improvement in the treatment.

Dr. Reddy says, “By touching base more frequently, we’re able to reinforce the diagnosis and the prognosis as well as ongoing treatment changes that we need to implement.” In line with this Rainbow Pediatric and eClinicalWorks, their vendor for electronic medical records, worked on implementing a pilot program for telemedicine. The project aimed to offer tele-visits for ADHD patients and their caregivers. The goal was to improve the access to care and at the same time uphold the Rainbow Pediatric’s high standards of care. The initial implementation of the remote medicine pilot program had 150 pediatric patients participating.

The pilot program has showed impressive results. Prior to the program, there was about 40% compliance with follow-up appointments. The telemedicine platform yielded a compliance of 71% among the ADHD patients. This is equivalent to a 77% improvement in attendance. Due to the success in meeting scheduled visits via the remote medicine platform, the parents were eager to make the telemedicine meetings as part of the regular service.

 

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