GAINESVILLE, Fla.—University of Florida pediatricians are among the first in the nation to use cyberspace and video technology to diagnose child abuse and neglect from hundreds of miles away.

The pilot telehealth initiative is aimed at curbing a problem of tragic scope in Florida. A total of 111,576 reports of suspected child abuse were called into the Florida Abuse Hotline Information System in Tallahassee during fiscal year 1997-98, and nearly 20,000 of these children were seen by trained health experts with the state-funded Child Protection Teams.

The telehealth system involves continuous Internet access, television and telephone linkage between University of Florida pediatricians who staff Child Protection Teams in Gainesville and Jacksonville, and with medical personnel at Florida community hospitals in St. Augustine and Orange Park. Another connection is to be established in Ocala next fall.

“We’re talking about quicker, less stressful and less expensive medical attention for children brought into a small town hospital who, in the past---if child abuse was suspected---would have to be transported to the nearest hub of specialty care,” said Dr. Jay Whitworth, medical director of the statewide child protection team program.

“We’re concerned first and foremost about protecting children who need to be protected and properly cared for and, secondly, about reducing the reporting of cases where medical findings do not indicate abuse or neglect,” said Whitworth, who also is UF professor of pediatrics based at the Children’s Crisis Center on the campus of University Medical Center in Jacksonville. “Certainly, we want to reduce the number of families who are investigated unnecessarily.”

“We anticipate this system will enable health professionals to quickly determine whether a child needs treatment or, in cases of suspected abuse or neglect, whether further medical evaluation and investigation are needed,” said Dr. Howard Rogers, a UF pediatrician who directs the Child Protection Team in Gainesville.

“Health professionals are increasingly trying to play it safe and do the right thing for the children,” Rogers said. “But to do so, they need quick and thorough medical consultation to get accurate answers to crucial questions before they can recommend a course of action for an injured child and decide whether to file a report with the abuse hotline.”

Rogers sees about 10 cases of suspected child abuse every week.

Florida’s telehealth project provides a round-the-clock audiovisual connection between the emergency room teams in the community hospitals and the Child Protection Team physicians and nurses. The use of video cameras, including a hand- held camera with zoom lenses, enable medical personnel to record both full views of a patient and close-up views of bruises and other injuries, which are transmitted to the TV monitors viewed by doctors and nurses on both ends of the line. X-ray images also can be transmitted by computer for simultaneous viewing and analysis by the specialists.

The system is designed with dedicated telephone lines so that the health professionals can talk in confidence with the injured child and with adults who brought the child in for emergency care.

Another phase of the pilot project involves training nurses who are at the front line in seeing children brought into emergency rooms for evaluation of injuries and sudden illness, thus expanding the role that nurses play in child abuse detection.

Whitworth said the system also will reduce travel time and costs for injured children, their families or guardians, and the health professionals who need to consult in medical evaluations and decision making.

Rogers notes that the ability to provide community medical personnel quick access to child abuse specialists for consultation is particularly important in the broad region served by the Gainesville and Jacksonville Child Protection Teams. The districts they serve encompass 20 counties.

Whitworth, nationally known for his expertise in the medical care of abused children, helped to conceive the telehealth project along with Children’s Medical Services of the State Department of Health and the Florida Developmental Disabilities Council. The disabilities council is now funding evaluation of the project, which Whitworth hopes will later be extended statewide to all 23 Child Protection Teams.

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