Background: For years, in Catalonia and in the rest of Spain, there has been a deficit and an unequal geographical distribution of health professionals specializing in pediatrics, especially in rural areas. Among the proposals to improve this situation is the promotion of the use of information and communication technologies (ICT) among users and professionals. Moreover, with the outbreak of COVID-19, the use of telehealth has become an essential tool, with an overall increase in non–face-to-face visits, including in primary care pediatrics. In this context, telemedicine, when used in primary care pediatrics, can be an effective means of improving families’ access to medical care. Currently, in Catalonia, telemedicine involving patients and health professionals is used in pediatric primary care through telephone consultation and asynchronous teleconsultation (eConsulta). Video consultation is in practice not used, although it could have different applications. Objective: The aim of this study is to evaluate the feasibility of a video consultation process with physical examination in acute pediatric pathology in rural areas among primary care professionals. In addition, the level of satisfaction with these remote consultations will be assessed from the perspective of both the users and the health care professionals. Methods: We will conduct a prospective experimental study to analyze the possibility of using video consultation in pediatric acute care in primary care in central Catalonia (Spain). A minimum of 170 children aged between 0 and 14 years attending the primary care center (PCC) for acute illness for a period of 1 year will be included in the study. Initially, the telemetric visit, including a physical examination, will include a nurse at the patient and family’s side and a pediatrician who will participate remotely. Subsequently, the pediatrician will visit the patient in person and the physical examination and diagnosis made during the remote visit will be compared with the physical examination and diagnosis of the face-to-face visit, which is considered the gold standard. Results: Recruitment was planned to begin in the second half of 2023 and continue for at least 1 year. It is anticipated to be a good resource for a variety of acute pediatric conditions in primary care. The evaluation will focus on the feasibility of performing live remote visits and comparing their diagnostic accuracy with that of face-to-face visits. Conclusions: We believe that this study could provide evidence on the feasibility and diagnostic accuracy of video consultation in pediatric acute primary care in a rural setting, as well as on satisfaction with video consultations among both users and professionals. If proven useful in addressing the acute needs of children in a variety of situations, it could become a digital health tool that improves the overall pediatric primary care service in rural areas, for both families and professionals.
Background: In Catalonia, Spain, pediatric primary care is undergoing restructuring, including greater integration of information and communication technologies. The adoption of digital health solutions has also risen significantly since the onset of the COVID-19 pandemic. In areas with limited availability of healthcare professionals, digital tools are a key strategy for facilitating access to services and ensuring continuity of care. Objective: To evaluate the feasibility, diagnostic accuracy, and satisfaction of users and providers of an acute pediatric video consultation model, referred to as video interconsultation, that includes a remote physical examination and takes place between healthcare professionals, one of whom is physically present with the patient. Methods: This study aimed to evaluate the feasibility, diagnostic accuracy, and user and provider satisfaction of an acute pediatric video interconsultation model in a rural primary care setting in Catalonia. This 20-month prospective observational study included 200 cases involving children aged 0-14 years who received video interconsultations for acute conditions as part of routine practice. Each video interconsultation was conducted between a nurse physically present with the patient and a pediatrician connected virtually, and incorporated a virtual physical examination using a digital camera, video otoscope, and digital stethoscope. All patients were subsequently assessed in person. Evaluated outcomes were feasibility, diagnostic accuracy, consultation duration, and satisfaction among users and healthcare providers. Results: The video interconsultation model was feasible in 64.5% of cases, achieving 78.2% diagnostic agreement with subsequent in-person examinations. Mean accuracy was 0.99 (95% CI 0.98–1.00), with a specificity of 0.99 (95% CI 0.98–1.00) and a sensitivity of 0.90 (95% CI 0.84–0.95). Diagnostic agreement was highest for otoscopic, oropharyngeal, and dermatologic examinations, and lowest for abdominal assessments. Video consultations lasted approximately twice as long as in-person visits. Satisfaction was high, with 94.5% of users and 74% of providers rating their experience positively. Conclusions: Video interconsultations involving physical examinations and interprofessional collaboration appear to be a feasible, accurate, and well-received model for managing multiple acute pediatric conditions. This model may improve access to care in rural primary care and help reduce disparities in healthcare delivery. However, further research is needed to determine the specific settings in which this approach may be most beneficial, as well as its potential limitations in diverse clinical settings.