Daycare Telemedicine Pilot

One of the concerns about placing your children in daycare is what happens when they get sick.
Naturally, you don’t take a sick child to daycare, so we’re talking about those children who develop symptoms after parents drop them off. Telemedicine is playing a role in a healthcare pilot in the Rochester, New York area. One daycare center uses telemedicine to present a child to a physician. You can watch the ABC News story below.

I’m all for saving time and providing convenient healthcare, but I have just a few thoughts about this – things the reporter did not mention. In order to do telemedicine in daycare, you would obviously need more than the vocal support of the parents. If I were running this pilot, the parents would have to sign waivers allowing the daycare center to present their children to a pediatrician who may not be their regular doctor. Before signing away any legal rights, I would want to know the physician’s name so that I could research his practice with his state licensing board, if for no other reason to make sure that the doctor did not have a disciplinary action against him (or her). The medical board Web site would also tell me his area of interest or specialty and where he received his training. Even then, I would want the daycare center policy to ask permission – for informed consent – if I couldn’t be present. (And, boy, the physician should document that the call was made and the consent given.) It does appear that, for the TV story at least, the mother of the child was a party to the telemedicine visit.

In the ABC story, a woman uses a video otoscope to help the remote physician examine a child’s inner ear. In some states, this might not be legal (or altogether wise) if the person acting as the “patient presenter” was not a licensed healthcare provider. At any rate, I would hope that daycare center employees would have training on how to do this and other medical exams. Not to suggest that anything inappropriate occurs in this daycare center, but it’s prudent to have more than one adult in the room with the child, just to lessen the possibility if a parent cannot be present. All of this can be overcome, and probably has, but the story just doesn’t tell us that.

One final note: In typical mainstream media fashion, ABC found a pediatrician who was anti-telemedicine to get “both sides” of the story.