Telemedicine and Pediatrics - Building a Technology-Based Collaborative in Montana

Claudia S.P. Fernandez

A chapter in From Clinical Practice to Public Health Applications - The Successful, Sustainable and Scalable Outcomes of the Clinical Scholars Program from IntechOpen

Abstract: Ranking 38th nationally for pediatricians/100,000 children, 66% of Montana's 56 counties have no pediatrician and pediatric subspecialists are scarce. Parents drive hundreds of miles to access care for their children, and providers often struggle with 24/7 responsibilities to their patients without clinical partners to share the burden. Our Clinical Scholars project, "Montana Pediatrics" (MP), created a collaborative community system of pediatric providers to address after-hours access and create capacity for virtual teamwork, integrating telemedicine with local knowledge and continuity of care. MP developed three lines of service: (1) on-demand evening/weekend care for every child in Montana, (2) full-time school-based pediatric healthcare for a tribal health program, and (3) care of Montana's children with medical complexity. Each service line required different approaches for implementation, scalability, and sustainability. Montana Pediatrics became a federally recognized 501(c)3 providing on-demand urgent care for approximately 260,000 children, regardless of the family's ability to pay. In March 2023, a $1 M sustaining grant expanded on-demand pediatric urgent care. Successes include providing more than 1500 telemedicine visits for the 2500 school children on one reservation, saving families more than 1 million miles of driving, and contracting with two additional tribal and urban Indian health programs. MP has garnered more than $2.5 million for improving systems of care for children with medical complexity generally and for children with type I diabetes specifically. Employing collaborative telemedicine-based clinical communities improves access to pediatric care in Montana, allowing for additional clinical innovation to improve access and health equity for Montana's children.

Keywords: pediatrics; telemedicine; rural; collaborative; Indian health; innovation; health inequity; Clinical Scholars (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
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Persistent link: https://EconPapers.repec.org/RePEc:ito:pchaps:330923

DOI: 10.5772/intechopen.115584

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