{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:06:12Z","timestamp":1779696372278,"version":"3.53.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T00:00:00Z","timestamp":1464739200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Background and Objectives:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">Prevailing regulatory and financing issues constrain dissemination of connected care despite evidence supporting acceptability, effectiveness, and efficiency. In this analysis we describe care provided over a 12-year period by Health-e-Access, an evidence-based, information-rich, connected care model designed to serve children with acute illness. We demonstrate the broad clinical capacity of this care model and key components imparting this capacity.<\/jats:italic>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Materials and Methods:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">Since 2001, Health-e-Access has been used in childcare, elementary schools, neighborhood after-hours sites, and a school for children with severe disabilities in Rochester, NY. With Health-e-Access, videoconference (preferably) or telephone enables parent, patient, and provider engagement. Technology includes the capacity for acquisition and exchange of a broad range of clinical observations, qualifying Health-e-Access as an information-rich model and differentiating it from multiple other connected care models commonly labeled telemedicine. Primary diagnoses recorded for completed visits were classified according to resources (technology, personnel, examination type) required to complete encounters appropriately.<\/jats:italic>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">Among 13,812 Health-e-Access visits initiated through June 2013, 98.2% were completed. Capacity for ear-nose-throat examination and close inspection of eye and skin were sufficient to identify positive findings supporting 95.2% of primary diagnoses. Videoconference and stethoscope were considered essential for observations required to rule out serious conditions often presenting in similar fashion to these 95%.<\/jats:italic>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">Health-e-Access included technology essential for establishing diagnoses, ruling out more serious conditions, and identifying problems beyond its scope. Regulations enabling and financing incentivizing replication of similar connected care models would benefit families and communities substantially. Observations challenge regulatory bodies and payers to support connected health services of comparable value.<\/jats:italic>\n                  <\/jats:p>","DOI":"10.1089\/tmj.2015.0161","type":"journal-article","created":{"date-parts":[[2015,12,24]],"date-time":"2015-12-24T08:14:15Z","timestamp":1450944855000},"page":"465-472","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Care Offered by an Information-Rich Pediatric Acute Illness Connected Care Model"],"prefix":"10.1177","volume":"22","author":[{"given":"Kenneth M.","family":"McConnochie","sequence":"first","affiliation":[{"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy E.","family":"Wood","sequence":"additional","affiliation":[{"name":"University of Rochester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Alarie","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Ronis","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine and UH Rainbow Babies and Children's Hospital"},{"name":"Case Western Reserve University School of Medicine and UH Rainbow Babies and Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,6,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-1253"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-1517"},{"key":"e_1_3_3_4_2","unstructured":"Goondough A. Texas medical panel votes to limit telemedicine practices in state. The New York Times. April 10 2015. Available at www.nytimes.com\/2015\/04\/11\/us\/texas-medical-panel-votes-to-limit-telemedicine-practices-in-state.html (last accessed April11 2015)."},{"key":"e_1_3_3_5_2","unstructured":"Modalh M. Telehealth index: 2015 physician survey. American Well June 2015. Available at https:\/\/americanwell.com\/introducing-american-wells-telehealth-index-2015-consumer-survey\/ (last accessed December11 2015)."},{"key":"e_1_3_3_6_2","unstructured":"Goodnough A. Modern doctors' house calls: Skype chat and fast diagnosis. The New York Times. July 11 2015. Available at https:\/\/urldefense.proofpoint.com\/v2\/url?u=http-3A__www.nytimes.com_2015_07_12_health_modern-2Ddoctors-2Dhouse-2Dcalls-2Dskype-2Dchat-2Dand-2Dfast-2Ddiagnosis.html&d=AwIGaQ&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLUQRxhA&r=fpuKBC1lSkb6IKcynV1s0LgAlrCfqtmhD_sJokFw9-te7cUi8kAEiipglmxkiouq&m=CbZmU_W9MhQoxTZspUkaLwHtg1DcjNtxLe-Uj2Wexvg&s=99UW3aHFSkUmHea9UO4kPpKdD69xTLOqiopogYZl9_A&e= (last accessed July14 2015)."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2006.12.308"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0335"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2009.0138"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2014.0032"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2014.0175"},{"key":"e_1_3_3_12_2","doi-asserted-by":"crossref","unstructured":"McConnochie KM. Potential of telemedicine in pediatric primary care. Pediatrics in Review. Online edition. Elk Grove Village IL: American Academy of Pediatrics 2006. Available at http:\/\/pedsinreview.aappublications.org\/content\/27\/9\/e58 (last accessed December 11 2015).","DOI":"10.1542\/pir.27.9.e58"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2015.0111"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2009.0112"},{"key":"e_1_3_3_15_2","volume-title":"Pediatric telephone protocols","author":"Schmitt BD","year":"2010","unstructured":"Schmitt BD, ed. Pediatric telephone protocols, 13th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2010.","edition":"13"},{"key":"e_1_3_3_16_2","unstructured":"National Center for Health Statistics Centers for Disease Control and Prevention. National hospital ambulatory medical care survey: 2010 emergency department summary tables. Table 13. Twenty leading primary diagnosis groups for emergency department visits by patient age and sex: United States 2010. Available at http:\/\/www.cdc.gov\/nchs\/data\/ahcd\/nhamcs_emergency\/2010_ed_web_tables.pdf (last accessed December11 2015)."},{"key":"e_1_3_3_17_2","unstructured":"National Hospital Ambulatory Medical Care Survey: 2011 Outpatient Department Summary Tables. Table 11. Twenty leading primary diagnosis groups for outpatient department visits: United States 2011. Available at http:\/\/www.cdc.gov\/nchs\/data\/ahcd\/nhamcs_outpatient\/2011_opd_web_tables.pdf (last accessed December11 2015)."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.67.5.687"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.70.5.802"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.76.2.167"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(87)80282-2"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-7610.00715"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1239918"},{"key":"e_1_3_3_24_2","unstructured":"Hsiao A McCarthy P Agarwal A Lee E Chen L. Reliability of telemedicine in the assessment of seriously ill children. Pediatrics 2015 (under review). Research presented at the American Academy of Pediatrics National Conference & Exhibition October 14 2011 Boston MA. Abstract available at https:\/\/aap.confex.com\/aap\/2011\/webprogram\/Paper13967.html"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.2307\/2955407"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0025727300037182"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/6.1.47"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01323010"}],"container-title":["Telemedicine and e-Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/tmj.2015.0161","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/tmj.2015.0161","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/tmj.2015.0161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:40:22Z","timestamp":1779694822000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/tmj.2015.0161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1089\/tmj.2015.0161"],"URL":"https:\/\/doi.org\/10.1089\/tmj.2015.0161","relation":{},"ISSN":["1530-5627","1556-3669"],"issn-type":[{"value":"1530-5627","type":"print"},{"value":"1556-3669","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6]]}}}