{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:47:57Z","timestamp":1792597677453,"version":"4.5.0"},"reference-count":43,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Telephone consultations for acutely injured children receiving care in emergency departments (EDs) in nonpediatric trauma centers frequently exclude direct communication and informed decision-making with parents. The use of telemedicine to facilitate real-time expert consultation and parental communication with pediatric trauma specialists is underexplored and may improve family experience and support clinical decision-making.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the impact of telemedicine on parent experience of care, parent distress, and transfer frequency for acutely injured children presenting to EDs in nonpediatric trauma centers.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This stepped-wedge cluster-randomized clinical trial recruited patients between November 30, 2020, and November 27, 2022. Participants included families of children younger than 18 years with acute physical trauma presenting to 1 of 10 nonpediatric trauma centers in northern California. Analyses were conducted between June 2023 and March 2026.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n EDs were randomized to use telemedicine following a standard telephone consultation or the standard of care (telephone consultation only) when consulting with pediatric trauma physicians.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes were parent experience of care and parent distress measured 3 days or more following the child's injury. Experience of care was measured using ED Consumer Assessment of Healthcare Providers and Systems (CAHPS) questions. Distress was measured using the State-Trait Anxiety Inventory Form Y survey. Modified intention-to-treat analyses were performed to evaluate outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study included 595 children with acute physical trauma with a mean (SD) age of 7.6 (5.1) years, of whom 369 (62.0%) were assigned to telemedicine and 226 (38.0%) to standard of care. Summary scores for parent experience of care 3 days post injury were similar between cohorts (adjusted mean difference [AMD], 0.041 [95% CI, \u22120.008 to 0.090;\n P<\/jats:italic>\n \u2009=\u2009.10]), as were parent distress summary scores (AMD, \u22120.031 [95% CI, \u22120.297 to 0.235;\n P<\/jats:italic>\n \u2009=\u2009.82]). The adjusted odds ratio for transfer of patients assigned to telemedicine was 0.59 (95% CI, 0.16 to 2.16;\n P<\/jats:italic>\n \u2009=\u2009.43). Subscale analyses found significantly higher parental ED discharge and\/or transfer experience ratings for patients assigned to telemedicine (AMD, 0.104 [95% CI, 0.023 to 0.186;\n P<\/jats:italic>\n \u2009=\u2009.01]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, telemedicine consultations did not differ statistically significantly from standard care with respect to parent experience of care, distress, and transfer rates. Subscale analyses suggested a potential improvement with telemedicine consultations in parent experience related to ED discharge and interfacility transfers, highlighting a potential benefit in communication and preparation during care transitions.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04469036<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.36546","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:00:37Z","timestamp":1792594837000},"page":"e2636546","source":"Crossref","is-referenced-by-count":0,"title":["Telemedicine Consultation for Pediatric Trauma in Community ED Visits and Parent Experience of Care"],"prefix":"10.1001","volume":"9","author":[{"given":"James P.","family":"Marcin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, UC Davis School of Medicine, Sacramento, 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