Carla, an 18-year old young woman with autism, sits with her head down at the table. Jack, a 17-year old young man with autism, won’t sit in the doctor’s office and becomes aggressive. Mary, a 12-year old with autism, sits quietly in a doctor’s office, which is very challenging, if not nearly impossible.
After a new treatment delivery, Carla now happily engages with her practitioner. Jack now interacts and follows directions during his visits. And Mary is calm, happy and engaged when the practitioner works with her. The common denominator? Telemedicine.
Carla, Jack, Mary and many other children and adults with complex conditions are now interacting with their doctors and clinicians here at The Center for Discovery (TCFD) – via Telemedicine. They remain in the comfort of their homes or school, and literally dial up their practitioner for their appointment using a secure, compliant Internet connection with a camera and audio on a computer, laptop, tablet, or smart phone.
Maureen McSwiggan-Hardin, DNP, NP-P, Ph.D. at TCFD, says The Center has been increasingly utilizing telemedicine with positive reviews from the patients and their parents or caregivers. Telemedicine at TCFD began in the Pediatric Neurology Department several years ago and spread to the Food Exploration and Discovery Program (FED), which allowed therapists to treat and support families working on healthy eating and food behaviors in their own homes. The Behavioral Health Clinic is now conducting evaluation and follow-up appointments using the same technology.
There are a growing number of published research studies that support this new pathway to care. In fact, a 2018 meta-analysis of the use of Telemedicine specific to ASD, examined 14 different studies, all using two-way connectivity (where practitioner and patient saw and spoke to each other in real-time) and demonstrated overall beneficial results.
McSwiggan-Hardin says, “The parents and caretakers of the residents with ASD who have been cared for through Telemedicine at The Center have reported greater access to psychiatric specialists, more participation of the individual’s treatment team during the appointment in a more comfortable residential, school or home setting.” Visiting a doctor or clinician in an office can be very difficult for individuals with autism. McSwiggan-Hardin adds “Accessing a doctor or clinician from home eliminates the complexities of travelling, provides a much more relaxed atmosphere, and in a residential setting, it allows that individual’s aides and support team to participate in the appointment.” The clinicians at TCFD even noticed increased patient interest in the appointment with the use of a computer screen instead of typical face-to-face contact in an office. “For some, it helps them stay focused in the session, and on the interaction with the clinician,” says McSwiggan-Hardin.
The Center is actively exploring other possibilities using Telemedicine, which may include team consultations with multiple specialists. Telemedicine is being more widely leveraged across the country. The American Telemedicine Association (ATA), American Psychiatric Association (APA), and the American Academy of Child and Adolescent Psychiatry (AACAP) all provide published guidelines for pediatric and psychiatry providers in the use of Telemedicine that focus on technical connections, patient/caregiver safety and privacy, and best practices for setting up space and interventions. The current Telemedicine connectivity at TCFD is via a HIPAA protected secure connection with full room video access allowing two-way audio and video access.
For more information, please contact the Office of Strategic Outreach and Partnerships at StrategicOutreach@tcfd.org.