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Rural health, telemedicine and access for pediatric surgery

Kohler, Jonathan E.a; Falcone, Richard A. Jrb; Fallat, Mary E.c

Current Opinion in Pediatrics: June 2019 - Volume 31 - Issue 3 - p 391–398
doi: 10.1097/MOP.0000000000000763
SURGERY: Edited by Grace Z. Mak and Jessica J. Kandel

Purpose of review Access to care for children requiring pediatric general or specialty surgery or trauma care who live in rural areas remains a challenge in the United States.

Recent findings The expertise of specialists in tertiary centers can be extended to rural and underserved areas using telemedicine. There are challenges to making these resources available that need to be methodically approached to facilitate appropriate relationships between hospitals and providers. Programs, such as the National Pediatric Readiness Project and the HRSA Emergency Medical Services for Children Program enhance the capability of the emergency care system to function optimally, keep children at the home hospital if resources are available, facilitate transfer of patients and relationship building, and develop necessary transfer protocols and guidelines between hospitals.

Summary Telehealth services have the potential to enhance the reach of tertiary care for children in rural and underserved areas where surgical and trauma specialty care is not readily available, particularly when used to augment the objectives of national programs.

aDivision of Pediatric Surgery, American Family Children's Hospital and the University of Wisconsin, Madison

bDivision of Pediatric Surgery, Cincinnati Children's Hospital and the University of Cincinnati, Cincinnati

cDivision of Pediatric Surgery, Norton Children's Hospital and the University of Louisville, Louisville, USA

Correspondence to Mary E. Fallat, MD, Hirikati S. Nagaraj Professor of Surgery, Division Director, Pediatric Surgery, University of Louisville, Surgeon-in-Chief, Norton Children's Hospital, 315 E. Broadway Suite 565, Louisville, KY 40202, USA. Tel: +1 502 629 8638; fax: +1 502 583 9735; e-mail:

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