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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Using Telemedicine to Improve the Care Delivered to Sexually Abused Children in Rural, Underserved Hospitals

Kristen J. MacLeod, James P. Marcin, Cathy Boyle, Sheridan Miyamoto, Robert J. Dimand and Kristen K. Rogers
Pediatrics January 2009, 123 (1) 223-228; DOI: https://doi.org/10.1542/peds.2007-1921
Kristen J. MacLeod
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James P. Marcin
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Cathy Boyle
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Sheridan Miyamoto
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Robert J. Dimand
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Kristen K. Rogers
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Abstract

OBJECTIVE. We used live telemedicine consultations to assist remote providers in the examination of sexually assaulted children presenting to rural, underserved hospitals. We hypothesized that telemedicine would increase the ability of the rural provider to perform a complete and accurate sexual assault examination.

PATIENTS AND METHODS. Child abuse experts from a university children's hospital provided 24/7 live telemedicine consultations to clinicians at 2 rural, underserved hospitals. Consultations consisted of videoconferencing to assist in the examination and interpretation of findings during live examinations. Consecutive female patients <18 years of age presenting to the 2 participating hospitals were included. We developed and used an instrument to assess the quality of care and the interventions provided via telemedicine as it related to patient history, physical examination, colposcopic and manual manipulation techniques, interpretation of findings, and treatment plans for victims of child sexual abuse.

RESULTS. Data from 42 live telemedicine consultations were analyzed. The mean duration of the consultations was 71 minutes (range: 25–210 minutes). The consultations resulted in changes in interview methods (47%), the use of the multimethod examination technique (86%), and the use of adjunct techniques (40%). There were 9 acute sexual assault telemedicine consults that resulted in changes to the collection of forensic evidence (89%). Rankings of practitioners' skills and the telemedicine consult effectiveness were high, with the majority of cases scoring ≥5 on a 7-point Likert scale.

CONCLUSIONS. The use of telemedicine to assist in the examination of sexually assaulted children presenting to underserved, rural communities results in significant changes in the methods of examination and evidence collection. It is possible that this model of care results in increased quality of care and appropriate forensic evidence collection.

  • telehealth
  • child sexual abuse
  • nonaccidental trauma
  • quality of care
  • telemedicine
  • Accepted April 17, 2008.
  • Copyright © 2009 by the American Academy of Pediatrics

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Pediatrics
Vol. 123, Issue 1
January 2009
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Using Telemedicine to Improve the Care Delivered to Sexually Abused Children in Rural, Underserved Hospitals
Kristen J. MacLeod, James P. Marcin, Cathy Boyle, Sheridan Miyamoto, Robert J. Dimand, Kristen K. Rogers
Pediatrics Jan 2009, 123 (1) 223-228; DOI: 10.1542/peds.2007-1921

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Using Telemedicine to Improve the Care Delivered to Sexually Abused Children in Rural, Underserved Hospitals
Kristen J. MacLeod, James P. Marcin, Cathy Boyle, Sheridan Miyamoto, Robert J. Dimand, Kristen K. Rogers
Pediatrics Jan 2009, 123 (1) 223-228; DOI: 10.1542/peds.2007-1921
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