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Pediatric Remote Consultation Network — Case Study

Pediatric Remote Consultation Network — Case Study

Case Study

DreamzTech built a paediatric video-consultation platform for a 6-metro children's hospital system with paediatrician-only video routing, dual-parent consent flows for separated families, school-nurse async handoff workflow, FHIR R4 integration with Epic, and a Spanish-language patient pathway. Non-urgent paediatric ER visits in the service area dropped 61% in the first year.

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Pediatric Remote Consultation Network — Case Study
Pediatric Remote Consultation Network — Case Study
Pediatric Remote Consultation Network — Case Study
Pediatric Remote Consultation Network — Case Study
Pediatric Remote Consultation Network — Case Study
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Quick Answers

  • What we built: Pediatric Video-Consultation Platform
  • Who it's for: Children's Hospital Networks & Pediatric Practices
  • Delivery: End-to-end Product Development

  • 1. Parent Intake: Parents complete a structured chief-complaint form and verify dual-parent consent (where applicable) before scheduling.
  • 2. Pediatrician Routing: System routes only to paediatrician-only video pools — no general-practitioner fallback to preserve specialty integrity.
  • 3. Video Consultation: HIPAA-compliant video on Vonage Video API with parent + child + paediatrician simultaneously joining.
  • 4. School-Nurse Handoff: Async workflow lets school nurses send structured chief-complaint forms when a child is sent home from school.
  • 5. FHIR-to-Epic Sync: Visit summary, prescriptions, and clinical notes write back to the hospital's Epic EHR via SMART on FHIR.

Overview

The platform is a paediatric-specific video-consultation network purpose-built for a children's hospital system spanning 6 metropolitan service areas. It addresses the unique workflows of paediatric care — dual-parent consent, school-nurse handoff, paediatrician-only routing — while maintaining bi-directional integration with the hospital's Epic EHR and a fully translated Spanish-language patient pathway.

Challenges

  • Paediatric ER was overwhelmed with non-urgent paediatric visits resolvable by video consultation
  • Existing telehealth tools lacked paediatric-specific consent flows for separated/divorced parents
  • School nurses had no async pathway to escalate concerns to the paediatric service line
  • Spanish-speaking families had limited access to paediatric specialists
  • No FHIR R4 writeback to Epic meant duplicate documentation for paediatricians

  • 1. Parent Intake: Parents complete a structured chief-complaint form and verify dual-parent consent (where applicable) before scheduling.
  • 2. Pediatrician Routing: System routes only to paediatrician-only video pools — no general-practitioner fallback to preserve specialty integrity.
  • 3. Video Consultation: HIPAA-compliant video on Vonage Video API with parent + child + paediatrician simultaneously joining.
  • 4. School-Nurse Handoff: Async workflow lets school nurses send structured chief-complaint forms when a child is sent home from school.
  • 5. FHIR-to-Epic Sync: Visit summary, prescriptions, and clinical notes write back to the hospital's Epic EHR via SMART on FHIR.

How the platform works

  • 1. Parent Intake: Parents complete a structured chief-complaint form and verify dual-parent consent (where applicable) before scheduling.
  • 2. Pediatrician Routing: System routes only to paediatrician-only video pools — no general-practitioner fallback to preserve specialty integrity.
  • 3. Video Consultation: HIPAA-compliant video on Vonage Video API with parent + child + paediatrician simultaneously joining.
  • 4. School-Nurse Handoff: Async workflow lets school nurses send structured chief-complaint forms when a child is sent home from school.
  • 5. FHIR-to-Epic Sync: Visit summary, prescriptions, and clinical notes write back to the hospital's Epic EHR via SMART on FHIR.

Solutions delivered

DreamzTech built a paediatric-specialised video-consultation platform with workflows tailored to children's care, family dynamics, and school-health partnerships:

HIPAA-compliant video on Vonage Video API (BAA-covered)Multi-party video supporting parent + child + paediatrician simultaneouslyOptimised for tablet and mobile (the predominant family device)Pre-session triage form to surface red-flag symptoms
Configurable consent matrix supporting joint custody, sole custody, and stepparent scenariosE-signature workflow with audit trail for legal complianceConsent-revocation handling with notification chainSpanish-language consent pathway translated and legally validated
Async portal for school nurses to send structured chief-complaint formsChain-of-custody from school nurse → paediatrician → parent → school nurseAttendance-policy-friendly turnaround for return-to-school decisionsHIPAA-compliant identity verification for school nurse access
Bi-directional sync of patient demographics, encounters, vitals, prescriptionsEpic App Orchard certified with SMART on FHIR launch flowVisit notes written back as FHIR DocumentReference resourcesPrescription routing via NCPDP SCRIPT for outpatient pharmacy
Full UI translation reviewed by certified medical translatorsOptional Spanish-speaking paediatrician routing where availableTranslated parent education and post-visit instructionsCulturally-aware consent and disclosure flows
Age-appropriate growth chart integration with FHIR ObservationVaccination history view from FHIR ImmunizationCommon paediatric symptom decision-support promptsAllergic-reaction red-flag alerting with auto-escalation to ER if needed

Success Metrics

-61% Non-Urgent ER Visits

Non-urgent paediatric ER visits in service area dropped 61% in the first year of platform availability

14-Min Avg Resolution

Average video-consult-to-resolution time of 14 minutes — faster than office visits and ER triage

92% Parent NPS

Parent Net Promoter Score of 92% in first-year survey — among the highest in paediatric digital health

6 Metros Live

Platform operational across 6 metropolitan service areas with paediatrician-only routing

Spanish + English

Fully translated Spanish patient pathway with culturally-validated consent and post-visit instructions

Epic FHIR R4 Sync

Visit notes, prescriptions, and vitals write back to Epic via SMART on FHIR + DocumentReference

Conclusion

The platform addressed the paediatric ER overload problem by routing non-urgent paediatric concerns to a dedicated video-consultation pathway with paediatrician-only routing, dual-parent consent flows, school-nurse handoff, and Epic FHIR R4 integration. By focusing exclusively on paediatric workflows rather than adapting a general-purpose telehealth tool, the network reduced non-urgent paediatric ER visits by 61% while maintaining specialty integrity and a 92% parent NPS.
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    Frequently Asked Questions (FAQ)

    The platform supports configurable consent matrices for joint custody, sole custody, and stepparent scenarios. E-signature is required from each authorised parent with full audit trail. Consent-revocation triggers a notification chain to relevant clinical and parent stakeholders.
    Yes — there is a dedicated async portal for school nurses to send structured chief-complaint forms when children are sent home unwell. Chain-of-custody flows from school nurse to paediatrician to parent and back. HIPAA-compliant identity verification protects school nurse access.
    Yes. The platform is Epic App Orchard certified with SMART on FHIR launch flow. Bi-directional HL7 FHIR R4 sync covers patient demographics, encounters, vitals, prescriptions (via NCPDP SCRIPT), and clinical notes (DocumentReference resource writeback).
    Yes. Full UI translation reviewed by certified medical translators, optional Spanish-speaking paediatrician routing where staffed, translated parent education and post-visit instructions, and culturally-validated consent and disclosure flows.
    Age-appropriate growth chart integration with FHIR Observation, vaccination history view from FHIR Immunization, common paediatric symptom decision-support prompts, allergic-reaction red-flag alerting with auto-escalation to ER protocols when warranted.
    Native iOS and Android apps optimised for tablet (the predominant family device), with biometric login, push notifications for appointment reminders, and offline support for visit summary review. Web access is also available.

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