March 15, 2012
Researchers from the RAND Corporation and other institutions have begun pilot-testing a web-based tool designed to help parents and adult caregivers determine whether to seek urgent medical attention for a sick child with flu-like symptoms.
The study is being conducted by RAND Health in two hospital emergency rooms in the Washington, D.C., area—Children's National Medical Center in the District of Columbia and Inova Fairfax Hospital in Falls Church, Va.
"The flu can cause severe illness, but in most cases it is mild," said Dr. Art Kellermann, director of RAND Health and an emergency medicine physician who helped develop a similar website for adults during the H1N1 flu virus crisis in 2009. "Helping parents make the right decision for their child could decrease the number of children needlessly exposed to other kids' germs in emergency rooms and clinics, lower health care costs and reduce the pressure on America's overburdened emergency care system."
The global outbreak of H1N1 flooded hospital emergency rooms across the United States with ill children and adults. Kellermann says many of these patients could have been treated by their primary care physician or simply recovered at home.
To safely reduce demand on crowded ERs, in 2009 a volunteer group of medical and public health experts developed a free web-based tool to help adults with the flu determine where and when to seek care. The tool was named "Strategy for Off-Site Rapid Triage" (SORT). Although a pediatric version of SORT was envisioned at the time, it was not deployed.
RAND Health has now launched a pilot study to test whether a pediatric version of SORT can safely determine if a child who has flu-like illness needs immediate care in a hospital emergency room, can wait to see their pediatrician, can be seen in a walk-in or retail clinic, or can safely recover at home.
During this pilot, the website will only be accessible to parents and guardians who bring a sick child to one of the two emergency rooms involved in the study. Adult caregivers who agree to participate will answer a short sequence of online questions about the child's symptoms and any underlying health problems.
Children will be treated as usual in the hospital emergency rooms. But researchers will subsequently analyze information from the web-based tool and children's medical care to evaluate the potential usefulness of the SORT system for children.
The guidance SORT provides closely follows a clinical algorithm developed for physicians and call centers by the Centers for Disease Control and Prevention, and the American Academy of Pediatrics.
Funding for this study is provided by the de Beaumont Foundation, a private philanthropy dedicated to improving the effectiveness and capacity of local and state health departments.
"The de Beaumont Foundation is pleased to support the pilot study for this exciting new web-based tool," said Dr. James B. Sprague, chairman and CEO of the Foundation. "By helping parents or guardians make informed decisions about the needs of their children, SORT for Kids has the potential to reduce needless health care costs during regular flu seasons and blunt health system surge during future influenza pandemics."
Walgreens Pharmacies has donated gift cards to recognize study participants for sharing their time.
"Walgreens is a national leader in flu prevention, providing more flu vaccinations through our 7,800 pharmacies than anyone other than the U.S. government," said Suzanne Hansen, Walgreens group vice president of pharmacy operations. "But when the flu strikes, it's important that people seek the appropriate level of care. Not only will that help free up emergency rooms for those with the most serious and acute needs, but it also can help control total health care costs."
Children's National Medical Center is the only pediatric-exclusive hospital in the metropolitan Washington area. The lead researcher at CNMC is Dr. Daniel Fagbuyi, a national expert in pediatric emergency medicine.
Inova Fairfax Hospital is a 833-bed regional medical center that serves as the flagship hospital for the Inova Health System. The lead researcher at Inova Fairfax is Dr. Daniel Hanfling, a national expert in disaster preparedness.
The de Beaumont Foundation believes that a strong public health system is essential. Through strategic and engaged grant making, the Foundation is working to transform the practice of public health by building the capacity and stature of the public health workforce, encouraging collaboration between health departments, and improving communication with the public, especially through the use of technology.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.