Evaluation of a pilot paediatric concussion telemedicine programme for northern communities in Manitoba

• Published in: International Journal of Circumpolar Health
• Main Authors: Michael J. Ellis, Susan Boles, Vickie Derksen, Brenda Dawyduk, Adam Amadu, Karen Stelmack, Matthew Kowalchuk, Kelly Russell
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2019
• Subjects: concussion; paediatric; telemedicine; multi-disciplinary management; Arctic medicine. Tropical medicine; RC955-962; Arctic; Canada; Circumpolar Health; International Journal of Circumpolar Health
• Online Access: https://doi.org/10.1080/22423982.2019.1573163; https://doaj.org/article/805c18f8130b4db8b3e0a563a9f9df7c

Pediatric concussion patients living in northern communities in Canada can face unique challenges accessing primary and specialized healthcare. In this study we report the clinical characteristics, healthcare utilization, outcomes and estimated cost avoidance associated with a pilot pediatric concussion telemedicine program established between a multi-disciplinary pediatric concussion program in Winnipeg, Manitoba and a hospital in Thompson, Manitoba. From October 1st- July 1st, 2018, 20 patients were evaluated; mean age 13.1 years, 15 (75%) males and 14 (70%) self-identified as Indigenous. Injury mechanisms included hockey (50%), falls (35%) and assaults (15%). Median time from referral to initial consultation was 2.0 days. After screening by the neurosurgeon, 90% of patients underwent initial consultation via real-time videoconferencing with 80% managed exclusively through telemedicine. At the end of the study, 90% met the criteria for clinical recovery, one remained in treatment and one was discharged to a headache neurologist. Sixty-six telemedicine encounters were completed including 57 videoconferencing appointments and 9 telephone follow-ups representing an estimated cost avoidance of $40,972.94. This study suggests telemedicine may be a useful approach to assist pediatric concussion programs with delivering timely, safe and cost-effective care to patients living in medically underserviced remote and northern communities in Canada.