{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T18:13:00Z","timestamp":1785607980964,"version":"3.56.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000},"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":[[2019,11]]},"abstract":"\n \n Background:<\/jats:bold>\n Children with medical complexity (CMC) are high utilizers of health care services. Telehealth encounters may provide a means to improve care outcomes for this population.\n <\/jats:italic>\n <\/jats:p>\n \n \n Objective:<\/jats:bold>\n To evaluate the feasibility, usability, and impact of an in-home telehealth device in the care of CMC.\n <\/jats:italic>\n <\/jats:p>\n \n \n Methods:<\/jats:bold>\n This single-center feasibility study employed a nonblinded randomized clinical trial design. English-speaking caregivers of children within a pediatric complex care program with home Wi-Fi were eligible for participation. Participants were randomized 1.5:1 with stratification based on tracheostomy status to a control group that received usual care or an intervention group that received a telehealth device for in-home use. Patients were followed up for 4 months. The primary outcome was successful device connectivity and data transmission. Data included clinician encounter device usability; caregiver satisfaction; and encounter type, purpose, and cost. Descriptive statistics, negative binomial regression, and Kaplan\u2013Meier plot were used for analysis.\n <\/jats:italic>\n <\/jats:p>\n \n \n Results:<\/jats:bold>\n Twenty-four patients were enrolled (9 controls, 15 in the intervention group) in September 2016. The telehealth device was attempted in 73 encounters. Device connectivity was successful 96% of the time. Image and sound quality were acceptable in 98% of visits. Caregivers expressed their overall satisfaction with the device. The hospitalization rate was lower in the intervention group (0.77 vs. 1.14 intensive care unit days\/patient-months), resulting in $9,425\/USD per patient savings compared with the control group.\n <\/jats:italic>\n <\/jats:p>\n \n \n Conclusion:<\/jats:bold>\n Despite small sample size and short observation period, this study demonstrated that use of an in-home telehealth device is feasible, well received by caregivers, and can result in decreased hospitalizations when compared with usual care.\n <\/jats:italic>\n <\/jats:p>","DOI":"10.1089\/tmj.2018.0186","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T11:23:01Z","timestamp":1547119381000},"page":"1123-1132","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":64,"title":["Home-Based Telemedicine for Children with Medical Complexity"],"prefix":"10.1177","volume":"25","author":[{"given":"Patricia M","family":"Notario","sequence":"first","affiliation":[{"name":"Billings Clinic, Billings, Montana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Gentile","sequence":"additional","affiliation":[{"name":"Advocate Children's Hospital, Oak Lawn, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Amidon","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee, Wisconsin."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Angst","sequence":"additional","affiliation":[{"name":"Advocate Health Care, Downers Grove, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Lefaiver","sequence":"additional","affiliation":[{"name":"Advocate Children's Hospital, Oak Lawn, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Webster","sequence":"additional","affiliation":[{"name":"Advocate Children's Hospital, Oak Lawn, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,11,6]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3266"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-5-8"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.161.10.937"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1255D"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.122"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2005.03.007"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.02.002"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2698"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-1517"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2016.07.012"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X15610720"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13407"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X14555620"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2016.11.006"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.3928\/00904481-20140127-11"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.3928\/00904481-20140127-10"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.3928\/00904481-20140127-08"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.3928\/00904481-20140127-07"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2014.0175"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2017.0116"},{"key":"e_1_3_5_22_2","unstructured":"2016 Broadband Progress Report. Hearing before the Federal Communications Commission. FCC 16-6; 2016. 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