TY - JOUR
T1 - Impact of telemedicine on the quality of forensic sexual abuse examinations in rural communities
AU - Miyamoto, Sheridan
AU - Dharmar, Madan
AU - Boyle, Cathy
AU - Yang, Nikki H.
AU - MacLeod, Kristen
AU - Rogers, Kristen
AU - Nesbitt, Thomas
AU - Marcin, James P.
N1 - Funding Information:
This work was supported, in part, by grants from Maternal and Child Health Bureau of Health Resources and Services Administration (HRSA R40MC08723 ) and the William Randolph Hearst Foundation . The funding sponsors had no involvement in study design, collection, analysis, interpretation of the data, or writing the report, or the decision to submit the results of this work for publication.
Publisher Copyright:
© 2014 Elsevier Ltd.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - To assess the quality and diagnostic accuracy of pediatric sexual abuse forensic examinations conducted at rural hospitals with access to telemedicine compared with examinations conducted at similar hospitals without telemedicine support. Medical records of children less than 18 years of age referred for sexual abuse forensic examinations were reviewed at five rural hospitals with access to telemedicine consultations and three comparison hospitals with existing sexual abuse programs without telemedicine. Forensic examination quality and accuracy were independently evaluated by expert review of state mandated forensic reporting forms, photo/video documentation, and medical records using two structured implicit review instruments. Among the 183 patients included in the study, 101 (55.2%) children were evaluated at telemedicine hospitals and 82 (44.8%) were evaluated at comparison hospitals. Evaluation of state mandatory sexual abuse examination reporting forms demonstrated that hospitals with telemedicine had significantly higher quality scores in several domains including the general exam, the genital exam, documentation of examination findings, the overall assessment, and the summed total quality score (. p<. 0.05 for each). Evaluation of the photos/videos and medical records documenting the completeness and accuracy of the examinations demonstrated that hospitals with telemedicine also had significantly higher scores in several domains including photo/video quality, completeness of the examination, and the summed total completeness and accuracy score (. p<. 0.05 for each). Rural hospitals using telemedicine for pediatric sexual abuse forensic examination consultations provided significantly higher quality evaluations, more complete examinations, and more accurate diagnoses than similar hospitals conducting examinations without telemedicine support.
AB - To assess the quality and diagnostic accuracy of pediatric sexual abuse forensic examinations conducted at rural hospitals with access to telemedicine compared with examinations conducted at similar hospitals without telemedicine support. Medical records of children less than 18 years of age referred for sexual abuse forensic examinations were reviewed at five rural hospitals with access to telemedicine consultations and three comparison hospitals with existing sexual abuse programs without telemedicine. Forensic examination quality and accuracy were independently evaluated by expert review of state mandated forensic reporting forms, photo/video documentation, and medical records using two structured implicit review instruments. Among the 183 patients included in the study, 101 (55.2%) children were evaluated at telemedicine hospitals and 82 (44.8%) were evaluated at comparison hospitals. Evaluation of state mandatory sexual abuse examination reporting forms demonstrated that hospitals with telemedicine had significantly higher quality scores in several domains including the general exam, the genital exam, documentation of examination findings, the overall assessment, and the summed total quality score (. p<. 0.05 for each). Evaluation of the photos/videos and medical records documenting the completeness and accuracy of the examinations demonstrated that hospitals with telemedicine also had significantly higher scores in several domains including photo/video quality, completeness of the examination, and the summed total completeness and accuracy score (. p<. 0.05 for each). Rural hospitals using telemedicine for pediatric sexual abuse forensic examination consultations provided significantly higher quality evaluations, more complete examinations, and more accurate diagnoses than similar hospitals conducting examinations without telemedicine support.
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U2 - 10.1016/j.chiabu.2014.04.015
DO - 10.1016/j.chiabu.2014.04.015
M3 - Article
C2 - 24841062
AN - SCOPUS:84908223633
VL - 38
SP - 1533
EP - 1539
JO - Child Abuse and Neglect
JF - Child Abuse and Neglect
SN - 0145-2134
IS - 9
ER -