This pilot study assessed the feasibility and acceptability of using telemedicine to provide comprehensive care to pediatric patients with bleeding disorders located far from specialty care centers. Telemedicine visits were conducted between a pediatrician's office 500 miles from a hemophilia treatment center and specialists. Over a period of 10 months, 13 visits were conducted for 10 patients aged 2 weeks to 16 years via monthly videoconferencing. Both patients and providers found the telemedicine visits to be satisfactory and convenient. They resulted in significant cost savings for patients and the treatment center compared to traditional in-person visits requiring travel. The study demonstrated that telemedicine can effectively deliver specialty hematology care to remote pediatric populations with hemostatic disorders.

1. ISTH 2015 Abstract Submission
Topic: Pediatric thrombosis and hemostasis
ISTH15ABS-2041
EXPANDING TELEMEDICINE TO MEDICAL HOMES FOR COMPREHENSIVE CARE DELIVERY FOR PERSONS
WITH HEMOSTATIC DISORDERS: A PILOT STUDY OF THE AMERICAN THROMBOSIS AND HEMOSTASIS
NETWORK (ATHN)/NATIONAL HEMOPHILIA PROGRAM COORDINATING CENTER (NHPCC).
Roshni Kulkarni* 1, Rebecca A. Malouin2, Colleen Vallad-Hix3, Laura Carlson1, Marcia Bird1, Diane Aschman4, Ann
Forsberg4, Zachary Trost1, Robert Greenhoe3
1Michigan State University, 2Michigan State Univeristy, East Lansing, 3Portage Health Pediatrics, Upper Great Lakes
Family Health Center , Hancock, 4American Thrombosis and Hemostasis Network, Riverwood, United States
Preferred Presentation Method: Oral or Poster
Travel Grant Application: I do not want to apply for a travel grant
Background: Telemedicine (TM) is the exchange of medical information from one site to another via electronic
communications to improve patients’ health status. Limited data exists about TM usage by hemophilia treatment center
to deliver comprehensive care, to remote pediatric patients with hemostatic disorder.
Aims: To assess feasibility of telemedicine between specialists and medical home for children with hemostatic disorders,
acceptability by patients, families, primary care physicians, primary care staff, specialist physicians, and specialist staff
and cost of telemedicine visits versus traditional visits.
Methods: TM site was the pediatrician’s office at the Upper Great Lakes Family Health Center in Hancock/Houghton, MI,
and 500 miles from Michigan State University (MSU) Center for Bleeding and Clotting Disorders (MSU CBCD). VidyoTM,
a synchronous HIPAA regulated bidirectional videoconferencing technology was used. Records of patient visits
diagnosis, travel distance time and costs, and interviews with physician staff and families were obtained. Measurable
objectives included feasibility, acceptability and cost of TM.
Results: Beginning June 2014, a total of 13 visits by 10 patients, ages 2 weeks -16 years and their families were seen via
monthly TM. Besides bleeding disorders, such as epistaxis, menorrhagia, von Willebrands disease etc., other
hematologic disorders were also seen. Eleven family members were tested. Patients incurred considerable cost savings
by obtaining care locally instead of flying (cost $1770) or driving (cost $1158) to MSU CBCD. The MSU CBCD team also
incurred significant cost savings. Patients, families and providers expressed satisfaction with the services. Besides
education of medical home providers, technology issues were also addressed.
Conclusion: TM with medical home in remote areas is feasible and acceptable. Besides satisfaction with the services
and there was considerable cost savings for both patients as well as the comprehensive care treatment team.
Disclosure of Interest: None Declared
Keywords: Cost-effectiveness, Haemostasis, Paediatric, Von Willebrand disease