51 Feasibility of paediatric postoperative telemedicine in Nunavik
Bibliographic record
Abstract
Abstract Background To access surgical care, Inuit children from Nunavik are relocated by plane to an urban tertiary hospital. Current processes that require an in-person follow-up appointment extend their stay away from home despite an overall low rate of postoperative complications. Telemedicine presents the opportunity to reduce this delay, but little is known about its feasibility for paediatric postoperative care in Nunavik. Objectives To determine the feasibility of paediatric postoperative telemedicine in Nunavik. Design/Methods In this mixed methods study using a convergent parallel design (August 2022 – May 2023), we recruited eleven healthcare providers who regularly interact with Inuit families of Nunavik. We conducted individual semi-structured in-depth interviews about postoperative care in this setting and analyzed the data thematically. In parallel, we conducted a narrative synthesis of the literature and gathered input from collaborators to assess the potential resources needed to enable postoperative telemedicine in the region. We then determined the capability for telemedicine in each of the fourteen villages of Nunavik using data provided by the regional health board. A meeting with specialists responsible for telemedicine in the region was held to discuss findings and future steps. We analyzed and compared qualitative and quantitative results to determine the degree of postoperative telemedicine readiness in the region. Results The main themes influencing the feasibility of telemedicine were general considerations for telemedicine use as a follow-up modality, patient characteristics most suitable for postoperative telemedicine, resources needed for telemedicine use as a follow-up modality, and the feasibility of postoperative telemedicine as determined by healthcare providers. All interviewees deemed paediatric postoperative telemedicine in this region feasible but highlighted conditions for its success. The narrative review uncovered limited literature on telemedicine use in Nunavik. As of January 2023, the two regional hospitals and three health centers had full capabilities for postoperative telemedicine. The nine other health centers had partial capabilities, mainly due to limited access to stable high-speed Internet and Internet bandwidth. Only regional hospitals had access to hospitalization, imaging, readaptation, and laboratory departments. The participating specialists deemed telemedicine feasible if patient load and burden of administrative work are manageable. Conclusion Postoperative paediatric telemedicine in Nunavik is feasible from a resource, healthcare providers and specialists standpoint. Leveraging centers with appropriate capacity would allow the increase in telemedicine usage in Nunavik. Next steps in this research program include interviews with families to evaluate their needs, preferences and attitudes toward postoperative paediatric telemedicine.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".