JMIR Publications

ABSTRACT

Background:

In Catalonia, Spain, pediatric primary care is undergoing restructuring, including greater integration of information and communication technologies. The adoption of digital health solutions has also risen significantly since the onset of the COVID-19 pandemic. In areas with limited availability of healthcare professionals, digital tools are a key strategy for facilitating access to services and ensuring continuity of care.

Objective:

To evaluate the feasibility, diagnostic accuracy, and satisfaction of users and providers of an acute pediatric video consultation model, referred to as video interconsultation, that includes a remote physical examination and takes place between healthcare professionals, one of whom is physically present with the patient.

Methods:

This study aimed to evaluate the feasibility, diagnostic accuracy, and user and provider satisfaction of an acute pediatric video interconsultation model in a rural primary care setting in Catalonia. This 20-month prospective observational study included 200 cases involving children aged 0-14 years who received video interconsultations for acute conditions as part of routine practice. Each video interconsultation was conducted between a nurse physically present with the patient and a pediatrician connected virtually, and incorporated a virtual physical examination using a digital camera, video otoscope, and digital stethoscope. All patients were subsequently assessed in person. Evaluated outcomes were feasibility, diagnostic accuracy, consultation duration, and satisfaction among users and healthcare providers.

Results:

The video interconsultation model was feasible in 64.5% of cases, achieving 78.2% diagnostic agreement with subsequent in-person examinations. Mean accuracy was 0.99 (95% CI 0.98–1.00), with a specificity of 0.99 (95% CI 0.98–1.00) and a sensitivity of 0.90 (95% CI 0.84–0.95). Diagnostic agreement was highest for otoscopic, oropharyngeal, and dermatologic examinations, and lowest for abdominal assessments. Video consultations lasted approximately twice as long as in-person visits. Satisfaction was high, with 94.5% of users and 74% of providers rating their experience positively.

Conclusions:

Video interconsultations involving physical examinations and interprofessional collaboration appear to be a feasible, accurate, and well-received model for managing multiple acute pediatric conditions. This model may improve access to care in rural primary care and help reduce disparities in healthcare delivery. However, further research is needed to determine the specific settings in which this approach may be most beneficial, as well as its potential limitations in diverse clinical settings.