1. Computer Technology and Pediatrics Nursing 140 Ashley Alexander Betsy Cockerham Brittany Pirko Rachel Werth

2. Computer Technology in Pediatrics  Telemedicine Systems  Child Health Improvement Through Computer Automation  JPL Software Links Pediatric Doctors With New Research

3. Telemedicine in Pediatrics  Telemedicine in pediatrics: is the use of electronic communications technology to provide and support health care for infants, children, adolescents, and young adults when distance separates the practitioner from the patient, parent, guardian, or referring practitioner

4. Telemedicine in healthcare  There are many different ways that telemedicine is useful in health care. Computers are used all throughout radiology, mental health, dermatology, cardiology, emergency and transport services, child abuse, school health, and many more

5. School health  Some school systems are experimenting with telemedicine links to lengthen the range of services of school- based clinics and lower absenteeism for illness and disease control problems

6. Child Abuse  Expertise in child abuse and neglect and the interdisciplinary communication that often is important for an adequate child- maltreatment investigation present challenges that telemedicine could help to address  It is helpful by the use of a software package specifically marketed for the sharing of still photographs in child abuse consultations

7. Other Services  Other services that have shown promising results using telemedicine include pediatric dentistry, neonatal ophthalmology, and interpretation of radiographs by Neonatologists

8. Research Problems  There are few studies that indicate that telemedicine has important implications for accessing pediatric subspecialty services  However it is shown that telemedicine does help in determining future health care requirements, and improving communications with parents of sick and ill children

9. Technological Advancements in Telemedicine  Telemedicine involves the delivery of medical the delivery of medical care over a distance using telecommunication technologies  Health care programs involving electronic communication are becoming more predominant throughout the nation  Telemedicine in pediatrics uses a combination of computerized technological advancements to improve the care of children throughout the nation.

10. Benefits of Telemedicine  Telemedicine allows health care providers to electronically interact with patients at remote cites  Since most rural area hospitals are not staffed with specialists in every area of pediatric care, telemedicine is becoming an effective way for specialists to treat children in urban areas  Telemedicine increases access to pediatric specialist health care services  It reduces medical expenses by decreasing the amount of patient travel and transportation time

11. Telemedicine  Telemedicine technology is considered to be “acceptable means of delivering specific pediatric subspecialty consultation services to children with special health care needs, living in rural areas” (“Use of”)

12. Telemedicine Equipment  Interactive audio and video capabilities by using: diagnostic quality cameras diagnostic quality cameras medical instrumentation medical instrumentation StethoscopeStethoscope OphthalmoscopeOphthalmoscope OtoscopeOtoscope

13. Telemedicine Equipment  This computerized technology allows: Image capture Image capture Image storage Image storage Image transfer Image transfer Interactive collaboration Interactive collaboration

14. Telemedicine Systems  Telemedicine systems allow doctors (located at major hospitals) to observe the actual examination of patients (located in rural areas) by using cameras and electronic medical instruments  The examinations are performed by the rural area clinic nurses

15. Telemedicine Systems  The doctors have immediate access to the images and data collected from the examinations and are therefore able to make a recommendation or diagnosis  The physician can then consult with the patient’s family via telecommunication capabilities  Telemedicine is a suitable alternative for children who live long distances from primary hospitals but it should not be the sole method a medical treatment

16. Georgia Study  A recent study in the state of Georgia confirmed that telemedicine is an effective way to improve and advance health care services  The Children’s Medical Services (CMS) of Georgia and the Pediatrics Department of the Medical College of Georgia (MCG) collaborated to develop a telemedicine program

17. Georgia Study  The program was enacted in order to provide appropriate care to children with special needs throughout the state  In general, the patients and their parents were satisfied with telemedicine services  Physicians and Faculty members attitudes concerning telemedicine improved as they became more experienced with the technology  This study showed that telemedicine has the potential to play a vital role in the future of health care services

18. Child Health Improvement Through Computer Automation CHICA System Combines Medical Guidelines with Information from Patient’s Family

19. New Technology in Pediatrics Latest innovation in medical care for children Latest innovation in medical care for children Blends “just-in-time” concept with increased parental participation Blends “just-in-time” concept with increased parental participation Produces care guidelines for pediatricians individualized for each patient that are delivered at the patient’s office visit. Produces care guidelines for pediatricians individualized for each patient that are delivered at the patient’s office visit.

20. How does it Work? Targets children instead of adults Targets children instead of adults Utilizes hand written information taken from child’s parents in waiting room along with preexisting data from country’s oldest operational medical record to provide information and clinical reminders to pediatricians Utilizes hand written information taken from child’s parents in waiting room along with preexisting data from country’s oldest operational medical record to provide information and clinical reminders to pediatricians

21. Introduction of CHICA Took place at MedInfo 2004 (the premier international meeting of the medical informatics community) Took place at MedInfo 2004 (the premier international meeting of the medical informatics community) Researchers introduced CHICA, which combines patient pediatric guidelines with history learned from the patient’s family. Researchers introduced CHICA, which combines patient pediatric guidelines with history learned from the patient’s family. Further enables physicians to provide individually targeted care. Further enables physicians to provide individually targeted care.

22. How it works… The parent or family member fills out a simple CHICA waiting room prescreening form which includes information, including reason for visit. The parent or family member fills out a simple CHICA waiting room prescreening form which includes information, including reason for visit. Responses scanned and uploaded into computer system Responses scanned and uploaded into computer system Items then used on customized form by physician Items then used on customized form by physician Information tracked from visit to visit. Information tracked from visit to visit.

23. Benefits of the CHICA system Information attained from families informs physicians of important clinical data such as guns within homes, abusive family situations, and maternal depression. Information attained from families informs physicians of important clinical data such as guns within homes, abusive family situations, and maternal depression. Information received from families would not have been known otherwise if not for CHICA system. Information received from families would not have been known otherwise if not for CHICA system.

24. About CHICA… CHICA is an extension of the Regenstrief Medical Records System (RMRS), a computer based inpatient and outpatient information system that contains more than 30 years of patient information. CHICA is an extension of the Regenstrief Medical Records System (RMRS), a computer based inpatient and outpatient information system that contains more than 30 years of patient information. Includes reminder system that offers suggestions regarding diagnosis, tests, and treatment. Includes reminder system that offers suggestions regarding diagnosis, tests, and treatment.

25. More Benefits… Busy pediatricians often have to rely on memory, and computerized guidelines can often be costly. Busy pediatricians often have to rely on memory, and computerized guidelines can often be costly. CHICA solves both the information overload and cost problems while helping the pediatrician focus on the patient’s specifics. CHICA solves both the information overload and cost problems while helping the pediatrician focus on the patient’s specifics.

26. How it Helps… “Combining pediatric preventative care guidelines with a dynamic scannable paper user interface enables [the physicians] to better serve [their] patients and their families.” “Combining pediatric preventative care guidelines with a dynamic scannable paper user interface enables [the physicians] to better serve [their] patients and their families.”

27. Beliefs for CHICA CHICA will enable the parents and physicians of 55,000 pediatric patients in the Wishard Health System (site of study), making better healthcare decisions. CHICA will enable the parents and physicians of 55,000 pediatric patients in the Wishard Health System (site of study), making better healthcare decisions. It is believed that CHICA will become an indispensable tool to many pediatricians and will gradually spread to other systems, improving pediatric healthcare. It is believed that CHICA will become an indispensable tool to many pediatricians and will gradually spread to other systems, improving pediatric healthcare.

28. JPL Software Links Pediatric Doctors With New Research Advancing Technology and Pediatric Healthcare

29. Engineers created a software that will connect information from various hospitals all over the world into one VIRTUAL intensive care unit. The system will link doctors who need detailed and specific information with researchers willing to share their data about pediatric medicine.

30. For example… If a pediatrician in NC wanted to find information about the most advanced treatment in for a child with bone cancer, he could search the database and find the latest medical studies conducted by researchers all over the country.

31.  The software is called Object Oriented Data Technology Software and was modeled after the Planetary Data System, which is a large software network that helps space scientists translate used in local databases into standard language.

32. Mars Similar software is used to support the Mars Exploration Rovers, currently exploring the martian environment. Similar software is used to support the Mars Exploration Rovers, currently exploring the martian environment.

33. What Led to The Use of This System Conjoined twins from Guatemala and the Philippines were separated after numerous surgeries in the US, since their communities lacked the quality medical care for the procedure.

34. Ctn’d… As a result, engineers at NASA’s Jet Propulsion Laboratory in Pasadena, CA, are working with doctors on a computer system that may soon allow high tech surgeries to be performed in a remote country using this virtual pediatric system.

35. The problem…  Dan Crichton, a JPL senior computer scientist, has stated that the problem is that information has been primarily used for local use, and now scientists are discovering the value of sharing research within various communities.

36. This has been true in Biomedicine, Planetary Medicine, and now in Pediatric medicine. Planetary medicine Biomedicine Pediatric Medicine

37. Educating Other Doctors Pediatricians can also record patient information directly from bedside monitors, using extended databases, regardless of their location. The computer system is also capable of storing the information so that other doctors can use it for clinical trials and help other doctors dealing with similair patients.

38. As of Now…  The virtual pediatric system is being developed and tested at the Los Angeles Children’s Hospital.  Next year it will be extended to the John Hopkins Children’s Center, Baltimore, and Cornell University Medical Center in NY.

39. “THE GOAL” The goal of the virtual pediatric system is to enable us to practice in one critical care unit where we will have all the latest information available to care for critically ill children, said Dr. Randall Wetzel, director of critical care medicine at Children’s Hospital in Los Angeles. The goal of the virtual pediatric system is to enable us to practice in one critical care unit where we will have all the latest information available to care for critically ill children, said Dr. Randall Wetzel, director of critical care medicine at Children’s Hospital in Los Angeles.

40. In the Next Few Years  This virtual pediatric intensive care unit is ideal for hospitals without advanced intensive care units. Engineers hope to install networked cameras in the next few years, allowing doctors to check on their patients in remote areas and assist their colleagues working in isolated centers.

41. Partnership The JPL Innovative Technology Transfer Partnerships Office has welcomed the opportunity to collaborate with outside companies to develop and transfer dual-use technology through NASA’s Innovative Partnership Program.The JPL Innovative Technology Transfer Partnerships Office has welcomed the opportunity to collaborate with outside companies to develop and transfer dual-use technology through NASA’s Innovative Partnership Program.

42. How Many? There are about 275 pediatric intensive care units around the country. There are about 275 pediatric intensive care units around the country. Also, every year about 50,000 infants and children who need constant care are admitted into these centers. Also, every year about 50,000 infants and children who need constant care are admitted into these centers.