Impact of Tele-Emergency Consultations on Pediatric Readiness and Quality of Care in General Emergency Departments: A Cluster-Randomized Crossover Trial (Telehealth for PEDS Readiness (Tele-ED))

The overall goal of our study is to determine whether telemedicine consultations improve Pediatric Readiness and the quality of care provided to acutely ill children presenting to community and rural EDs. Specific Aims: Specific Aim 1 (Primary): To determine the impact of ED telemedicine consultations on the efficiency and appropriateness of pediatric emergency care. We hypothesize that interfacility transfer rates and ED unscheduled return visits will be less likely when consultations are performed using telemedicine than when using the telephone. Specific Aim 2 (Secondary): To determine the impact of ED telemedicine consultations on guardian experience of care. We hypothesize that experience of care will be rated higher when consultations are performed using telemedicine than when using the telephone, as measured by ED Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey questions. Specific Aim 3 (Secondary): To determine the impact of ED telemedicine consultations on pediatric emergency quality of care. We hypothesize that the quality of care will be rated higher when consultations are done using telemedicine than when consultations are done using the telephone, as measured by chart review with the PECARN Implicit Review Instrument.