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There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20-150). The centres sent an average of 4.7 children home each month because of illness. Using telephone and face-to-face interviews,we assessed their perceived need for and familiarity with telemedicine, as well as their openness and preparedness for implementing telemedicine. Most day care centres reported a need for telemedicine and were open to learning how to use it. Some centres were concerned about adequate space for the equipment, but overall, the centres felt that their resources were adequate. Telemedicine in rural day care centres appears to be feasible, and would have the potential to save time and money for parents, as well as perhaps improving health care for children in rural areas. [ABSTRACT FROM AUTHOR]

We conducted a systematic review to identify studies on the effect of home telehealth on clinical care outcomes. The search was restricted to peer-reviewed publications (published between 2001 and 2007) about studies conducted in home or residential settings. The search yielded 154 potential articles and dissertations. A total of 29 articles met the inclusion criteria and were included in a meta-analysis. The weighted mean effect size for the overall meta-analysis was 0.50, and the z-statistic was 3.0, indicating that telehealth had a moderate, positive and significant effect (P ≤ 0.01) on clinical outcomes. Subanalyses also indicated positive significant effects of telehealth for some disease categories (heart disease and psychiatric conditions), but not others (diabetes), patient populations and telehealth interventions. Overall, the meta-analysis indicated that telehealth positively affects clinical outcomes of care, even in different patient populations. [ABSTRACT FROM AUTHOR]