When a child is sick enough to require hospitalization, timely diagnosis and treatment are critical. However, some hospitals may not have access to certain specialists, such as pediatric neurologists.
More than a quarter of hospitalized newborns and pediatric patients have an issue with the brain or nervous system. To help its hospital partners provide highly specialized care to these patients, Pediatrix® Medical Group recently introduced the Pediatrix TeleNeurology Program.
The program, led by Andy Kim, M.D., a board-certified, fellowship-trained pediatric neurologist, aims to provide pediatric neurology expertise to hospitalized patients whose symptoms indicate possible brain or nervous system conditions.
“Many hospitalized pediatric patients have something going on with the brain or nervous system, either as a secondary phenomenon resulting from another illness or as a primary disorder of the nervous system,” said Dr. Kim, Pediatrix TeleNeurology Program medical director. “If there are concerns that the brain or other parts of the nervous system aren’t working properly, intensive care providers can enlist our teleneurology services to help determine what’s going on and how best to treat it.”
The Pediatrix TeleNeurology Program
Pediatrix® Medical Group partners with nearly 1,200 hospitals and health care facilities nationwide, providing specialized care to patients in the neonatal intensive care unit (NICU), pediatric intensive care unit (PICU) and various pediatric wards. The Pediatrix TeleNeurology Program bridges a gap for Pediatrix hospital partners that don’t have access to on-site pediatric neurologists.
Unlike many telemedicine services that only conduct physician-to-physician consultations, Dr. Kim works directly with patients and their families at the bedside via video conferencing. While he cannot physically touch the patient, he collaborates with physicians, nurses and patients’ families to conduct a thorough bedside examination and gather the necessary information to arrive at the proper diagnosis.
“We don’t just read EEGs [a recording of brainwaves],” said Dr. Kim. “We provide a complete virtual teleneurology service where our experts are available for patient consults via video conference at the bedside. We begin by visiting with the patient’s parents, caretakers and providers to get a detailed account of the patient’s current illness and the patient and family’s medical history, which is how about 80% to 90% of diagnoses are made. I conduct a thorough chart review, going through all the information we have on the patient. Another key to reaching the diagnosis is through physical examination. A big part of the pediatric neurological exam is observation, so I usually don’t need to touch the patient during an examination. Watching the child and seeing how they act and move gives us a good sense of how their nervous system is working.”
During the virtual physical exam, Dr. Kim may ask the bedside care provider to perform specific actions, such as testing the child’s reflexes or shining a light in his or her eyes. At the same time, he observes the child’s responses. The physical exam is complemented by all available data, including family medical history, lab results, imaging and brain monitoring.
“Once I evaluate the patient and all available data, I make my assessment by making a list of the most likely and most critical diagnoses called a differential diagnosis,” said Dr. Kim. “I then make a list of additional tests necessary to land on the final diagnosis.”
Common Conditions Requiring Pediatric Neurology Expertise
The Pediatrix TeleNeurology Program offers consultations for various neurological conditions, such as:
- Ongoing headaches that are difficult to treat
- Encephalopathy (a disease that alters brain structure or function)
- Abnormal MRIs or CT scans of the brain or spinal cord
- Hypotonia (decreased muscle tone) or hypertonia (excessive muscle tone)
- Microcephaly (abnormally small head) or macrocephaly (abnormally large head)
- Birth defects of the brain and spinal cord
- Disorders of the peripheral nerves and muscles
- Nonsurgical treatment of brain injuries or masses
In addition, our neurologists specialize in treating newborns undergoing therapeutic hypothermia for presumed hypoxic ischemic encephalopathy (HIE), a condition caused by a lack of blood flow and oxygen to the brain. They work closely with neonatologists and NICU staff to provide the best possible neurologic and developmental outcomes.
Physicians in the Pediatrix TeleNeurology Program are board-certified and fellowship-trained in pediatric neurology. They have extensive training in EEG interpretation and pediatric neurological consultation. Before entering the program, they must undergo a rigorous credentialing process based on federal regulations and industry standards. They also must share Pediatrix Medical Group’s mission to “take great care of the patient, every day and in every wayTM.”
In addition to being virtually present at the patient’s bedside and involving family members in the child’s care, our neurologists collaborate with local physicians who will provide follow-up care with the patient after they are discharged from the hospital,” said Dr. Kim. “A seamless transition from inpatient to outpatient care helps secure long-term health and success for the patients entrusted to our care.”
Please visit our website to learn more about the Pediatrix TeleNeurology Program.