Evidence map›Paper›PMID 41121060›Full record

ArticleBMC health services research2025

Pathways to optimize a pediatric telemedicine and medication delivery service: a multi-level qualitative study in Haiti.

Molly B Klarman, Frantz Emmanuel Garilus, Kerven Cassion, Youseline Cajusma, Katelyn E Flaherty, Jude Ronald Beausejour, Lerby Exantus, Valery M Beau de Rochars, Chantale Baril, Torben K Becker and 2 more

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Molly B KlarmanDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, FL, USA. mklarman@ufl.edu.
Frantz Emmanuel GarilusDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, FL, USA.
Kerven CassionDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, FL, USA.
Youseline CajusmaDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, FL, USA.
Katelyn E FlahertyDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, FL, USA.
Jude Ronald BeausejourDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, FL, USA.
Lerby ExantusUniversité d'État d'Haiti- Faculté de Médecine et de Pharmacie, Port-au- Prince, Haiti.
Valery M Beau de RocharsDepartment of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA.
Chantale BarilUniversité d'État d'Haiti- Faculté de Médecine et de Pharmacie, Port-au- Prince, Haiti.
Torben K BeckerDepartment of Emergency Medicine, University of Florida, Gainesville, FL, USA.
Rochelle K RosenCenter for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.
Eric J NelsonDepartments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, FL, USA.

Funding

Improving Performance of a Pediatric TeleMedicine and Medication Delivery Service through mHealth TechnologyR33TW012332 · FIC · UNIVERSITY OF FLORIDA · PI Eric Jorge Nelson · 2025 to 2026
$864k
Improving Performance of a Pediatric TeleMedicine and Medication Delivery Service through mHealth TechnologyR21TW012332 · FIC · UNIVERSITY OF FLORIDA · PI NELSON, ERIC JORGE · 2023 to 2024
$395k
FIC NIH HHS R21 TW012332FIC NIH HHS R33 TW012332NIH HHS 5R21TW012332-02
6 · The paper itself

Abstract

backgroundWhile telemedicine has become an established component of healthcare delivery globally, challenges to scaling emerging initiatives persist across multiple levels. Over the last 5 years, our team has developed a pediatric telemedicine and medication delivery service (TMDS) in Haiti that integrates clinical guidance with rapid access to medications. Building on successful proof-of-concept studies, we are now well positioned to characterize both general challenges to telemedicine scale-up and those unique to the TMDS model.

methodsIn this descriptive qualitative study, we conducted focus group discussions and administered written questionaries to TMDS staff, including physicians, nurses, and medication delivery drivers. These qualitative survey instruments were designed to capture staff experiences and suggestions. Using framework matrix analysis, we identified key challenges and opportunities associated with the TMDS model.

resultsFourteen nurses, 13 drivers, and 3 on-call physicians participated in the study. Areas for improvement related to obtaining quality information from virtual exams, the reliability of technology and communication infrastructure, conditions necessary for effective in-person exams, the limited scope of the TMDS workflow and clinical resources, and uncertainty surrounding long-term sustainability. These insights informed the development of targeted potential solutions categorized into three domains: cognitive, physical and mission-oriented.

conclusionThe findings will guide our internal scale-up strategy and may offer guidance to similar telemedicine initiatives.

Indexed as

Drug Delivery SystemsPediatricsTelemedicineFocus GroupsHaitiHumansQualitative ResearchFramework matrix analysis, Telemedicine, Pediatrics, Scaling

Identifiers

PMID41121060
PMCPMC12539159

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.