Telemedicine in Pediatric Primary Care

Off-site pediatric consultation via bidirectional cable television (TV) was instituted to provide backup for nurse practitioners treating sick and well children in a small primary-care clinic. During a year of study of the system, there were 2,161 clinic visits and 285 TV consultations. When both TV and telephone consultation were available, TV was used for 10.8% of the visits, and telephone was used for 9.6% of visits. Staff reactions, though initially skeptical, were ultimately favorable. The system allowed pediatric nurse practitioners to function without on-site physician coverage 40% of the time. The main disadvantages were technical. Further work is needed to assess the reliability and validity of TV consultation and its acceptability in other settings. (JAMA240:2749-2751, 1978)