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Telecenter for secure, remote, collaborative child fatality review
  1. Mark R Zonfrillo1,2,
  2. Mahendra Kumar3,
  3. Jose A Fortes3,
  4. Flaura K Winston1,2,4
  1. 1Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  2. 2Department of Pediatrics, The Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  3. 3Department of Computer Science, University of Florida, Gainesville, Florida, USA
  4. 4Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Mark R Zonfrillo, Division of Emergency Medicine, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA; zonfrillo{at}


Objectives Child fatality review (CFR) is the systematic, interdisciplinary, multi-agency examination of paediatric deaths. While CFR findings may influence policies and reduce preventable fatalities, limited resources challenge accurate CFR data collection and prevention recommendations. Therefore, using technology to improve efficiency of reviews and access to remote participants could enhance the CFR experience. This project aimed to adapt a previously developed collaborative web-based appliance for remote, secure, collaborative review of crash investigations for use with CFR.

Methods The user-centred design and evaluation process included: (1) key informant interviews and visits to CFR sessions to determine current practices, (2) an anonymous, qualitative, internet-based survey of 64 Pennsylvania CFR team leaders, (3) redesign and adaptation of the Telecenter appliance based on survey results and team feedback and (4) pilot-testing of the adapted Telecenter application at an actual local CFR.

Results The qualitative informant interviews identified facilitators and barriers for adoption of the Telecenter. Facilitators included: team member training, improved communication and collaboration, more efficient reviews, and enhanced preventive efforts. Barriers identified included: concern for confidentiality and security, concern about accepting a novel CFR method, low interest in using technology, cost and maintenance. The survey of CFR team leaders identified themes for improving CFR team functioning including the need for evidence-based prevention resources, increased team training and efficient information gathering. The Telecenter was redesigned and adapted based on the information gathered and was successfully piloted for use with CFR.

Conclusions Telecenter met the design goal to improve information dissemination and identification of fatality prevention strategies for CFR.

  • Child
  • mortality
  • web-based
  • community research
  • motor vehicle occupant
  • epidemiology
  • disability
  • concussion
  • public health
  • child survival

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  • Funding This research was supported by the National Science Foundation Early-Concept Grant for Exploratory Research, grant numbers 10-42644 & 10-42642.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.