How Digital Innovations Are Radically Changing and Improving Children’s Health     

Virtual Health expands beyond traditional telemedicine and video-based visits.  It includes all non-traditional access points along the continuum of care. This includes health care kiosks in retail or pharmacy settings, virtual consoles in occupational health clinics, or even telemedicine carts in a school setting. Virtual health also includes mobile solutions such as consumer apps for chronic disease management, integration with wearable devices such as smart watches, and forward-thinking integration with point-of-care technologies that can test at home for flu, strep or more serious illnesses. It’s the whole gamut of solutions that will help provide the right care at the right time to align with the shift to the consumer-driven market.

To understand the value of virtual health, you need to understand the context. For many low-income families, the hospital emergency room has become the only source for receiving health care. An hourly paid parent can’t afford to miss a day’s wage to pick up a sick child from school for a doctor’s office visit. So they bring the child to the emergency room after work. The emergency room is a very expensive and inefficient place to deliver primary care, and patients with minor illnesses consume limited resources in that setting that are crucially needed for severely ill or injured patients.

So the question becomes: how can we make health care accessible to these children, enable them to stay at school, prevent parents from losing wages when their children are sick, and avoid unnecessary emergency room visits? Under Dr. Julie Hall-Barrow, the Children’s Health team has worked to make health care available in a school setting with the use of leading-edge, HIPAA-protected technology, and pioneered a school-based telemedicine program in 57 schools (and growing!) that gives North Texas students direct access to health care providers at Children’s Health.

Virtual Help and Real-Life Results

Here is how it works: the school nurse acts as a patient presenter. When a child doesn’t feel well, the child and patient presenter together meet with a health care provider at Children’s Health, via a secure videoconference. Based on the child’s complaints, the provider instructs the patient presenter to use a special scope to broadcast live video of a child’s ear canal, nasal passages, eyes, or throat. An electronic stethoscope transmits audio to enable the provider to hear lung and heart sounds. So the provider is able to remotely make a complete and accurate diagnosis while the child is at school, and even to prescribe medication that the parents can pick up at a pharmacy after work. The earlier intervention also helps ensure the child recovers more quickly and reduces absenteeism.

By providing a comprehensive technology plan and strategy for virtual health, the team at Children’s Health are creating “firsts” in the pediatric field — for example, the use of remote patient monitoring in pediatric kidney and liver transplant patients. Routine clinic visits are supplemented by giving patients devices that assess vitals, medication use and symptoms. The data is then reported in real time to a nurse, and key symptoms like vomiting or fever can prompt the nurse to call the family to investigate any potential complications. Families of patients with very recent transplants were highly responsive to the program because they didn’t have to travel to the clinic as frequently, and they felt reassured and supported in troubleshooting post-operative complications (we also had video consults during the initial days at home post-surgery).

Apps + Data + Innovation = Better Health  Care Intervention 

Children’s Health has also worked to develop My Asthma Pal, an app that provides children with asthma and their parents with a unique set of resources and tools to effectively and proactively manage their ailment. Parents who have children with this ailment can submit data on their child’s asthma condition using a mobile phone app and Bluetooth devices that provide location and medication usage in real-time. By collecting and monitoring this data, the medical team can identify opportunities for early medical interventions, reducing avoidable emergency room visits, as well as hospital inpatients and outpatient encounters.

Also, through technology we are able now, more than ever, to track lifestyle-related data that has not been previously available to providers.  For example, through Apple’s HealthKit, we are able to upload data to both “My Chart” (i.e. a patient portal) as well as through our own virtual health platform, Children’s Health Virtual Visit.  In addition, as more medical devices are Bluetooth- enabled, we can begin to collect real-time monitoring data such as blood pressure, weight, oxygen saturation and glucose readings. The upshot is that through all of this technology, Children’s Health is able to monitor and connect through live video to our most vulnerable populations. This ensures an ability to have real-time data that can provide a better lens for making changes in a health care plan.

While tremendous strides have been made in just the last few years within virtual health, the future is also very exciting. Increased regulatory and payer support are driving new innovations. Millennial parents are looking for investments in mobile solutions that can effectively drive health care modernization. We’ll see more virtual health data harnessed for predictive analytics that enable us to intervene before an adverse event occurs. Of course, in order to reach these goals, we must continue to evaluate new and emerging technological solutions with the same rigor we would apply to any potential best practice.

Written by: Julie Hall-Barrow, Vice-President Health & Innovation at Children’s Health Dallas