The use of telemedicine in pediatric psychology: research review and current applications.

Pediatric psychology represents the integration of psychological theories and applications for children and adolescents in the hospital setting. Moreover, research in this area has established empirically supported treatments in a variety of contexts, including Cystic Fibrosis, Diabetes, Obesity, and others. While such research has established the importance of the field in general, a number of areas within pediatric psychology remain to be studied in depth, and their applications described in detail. For example, research and reviews of clinical telemedicine applications for children and adolescents are currently in their early form. As evidence, this review represents the only review to date of telemedicine applications for children and adolescents diagnosed with a chronic illness. A majority of research in this area has focused on three specific themes, which were subsequently used to guide the organization of studies for this review (i.e., Feasibility/Cost-effectiveness, Clinical Outcomes/Assessment, and Patient/Provider Satisfaction). Generally, results from the studies reviewed suggest that telemedicine services for children and adolescents with chronic illnesses are feasible, cost-effective, and satisfying to patients. Some studies also suggest that telemedicine interventions may provide similar clinical outcomes to those expected from in-person service delivery. The broader pediatric chronic illness and telemedicine literature may inform future pediatric psychology applications (see Myers, Palmer, & Geyer, this volume). Similarly, lessons learned from NICU telemedicine programs may encourage further pediatric psychology practice over televideo [16,17]. In addition to a general description of the research to date on the subject, this review aimed to describe a number of telemedicine interventions for children and adolescents with a chronic illness that are currently being conducted our own academic medical center. This information may then provide insight into the various treatment modalities that can be used in the application telemedicine in the hospital setting (e.g., individual, multidisciplinary, and group interventions). Overall, the interventions described from our own experience suggest similar themes outlined by the studies reviewed above. Specifically, they suggest that telemedicine is a feasible and satisfactory way to provide most psychological treatments to children with chronic or acute illness and their families. While establishing feasibility and cost-effectiveness is important, and a majority of studies reviewed assessed for these features, more thorough examinations of clinical outcomes should be incorporated in future telemedicine interventions. In this way, health professionals can ensure that the quality of service and outcomes in telemedicine interventions are similar to those expected with usual care, and will be more confident suggesting such services to patients and other providers. In addition, once these outcome studies do exist, meta-analyses of this research base to establish quantitative inferences on the effectiveness of telemedicine interventions for children and adolescents with chronic illness will be very informative.