Charuta N Joshi1, Michele L Yang1, Krista Eschbach1, Suhong Tong1, Mona P Jacobson1, Chelsey Stillman1, Annmarie E Kropp1, Stephanie A Shea1, Gerard M Frunzi1, J Fred Thomas1, Christina A Olson1. 1. Division of Pediatric Neurology (CNJ, MLY, KE, MPJ, CS, AEK, SAS), University of Colorado School of Medicine, Anschutz Medical Campus, Children's Hospital Colorado, Aurora; Department of Pediatrics (ST), Children's Hospital Colorado, Aurora; Department of Biostatistics and Informatics (ST), Colorado School of Public Health, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora; Department of Pediatrics (JFT, CAO), University of Colorado School of Medicine, Anschutz Medical Campus, Children's Hospital Colorado, Aurora; and Telehealth Department (GMF, JFT, CAO), Children's Hospital Colorado, Aurora.
Abstract
OBJECTIVE: To examine whether telemedicine remains safe and of high quality despite rapid expansion of services by comparing telemedicine encounters before and during the COVID-19 pandemic. METHODS: Pre-post study investigating 2,999 telemedicine encounters: February 1, 2020-May 15, 2020, was performed. A total of 2,919 completed visits before and after strict social distancing implementation were analyzed for patient and provider characteristics, encounter characteristics (e.g., history and physical examination), and quality and safety metrics (phone calls ≤ 7 days postvisit, visit-cause-specific hospital admission or mortality ≤ 30 days after visit). Stratified analysis of 3 groups for outcomes (young age, neuromuscular diagnosis, and new encounters) was performed. RESULTS: Patients ranging from 1 month to 33 years of age were seen. Rural patients were less likely to be seen during the pandemic compared with urban patients (8% vs 90%; p < 0.0001); teaching clinic and specialty clinic encounters increased significantly during the pandemic (8% vs 3%; p = 0.005), and documentation of at least 2 systems on examination was noted significantly more frequently during the pandemic (13% vs 7%; p = 0.009). No deaths were reported. There were no differences before/during the pandemic in safety or telemedicine failure metrics within the entire group and high-risk subgroups. CONCLUSIONS: Despite a markedly and rapidly expanded scope of ambulatory telemedicine care during the COVID-19 pandemic, telemedicine remained a safe and high-quality option for pediatric neurology patients. In addition, populations perceived as high risk for telemedicine (the very young, new patients, and those with neuromuscular diagnoses) can benefit from telemedicine visits, particularly when access to in-person care is limited.
OBJECTIVE: To examine whether telemedicine remains safe and of high quality despite rapid expansion of services by comparing telemedicine encounters before and during the COVID-19 pandemic. METHODS: Pre-post study investigating 2,999 telemedicine encounters: February 1, 2020-May 15, 2020, was performed. A total of 2,919 completed visits before and after strict social distancing implementation were analyzed for patient and provider characteristics, encounter characteristics (e.g., history and physical examination), and quality and safety metrics (phone calls ≤ 7 days postvisit, visit-cause-specific hospital admission or mortality ≤ 30 days after visit). Stratified analysis of 3 groups for outcomes (young age, neuromuscular diagnosis, and new encounters) was performed. RESULTS: Patients ranging from 1 month to 33 years of age were seen. Rural patients were less likely to be seen during the pandemic compared with urban patients (8% vs 90%; p < 0.0001); teaching clinic and specialty clinic encounters increased significantly during the pandemic (8% vs 3%; p = 0.005), and documentation of at least 2 systems on examination was noted significantly more frequently during the pandemic (13% vs 7%; p = 0.009). No deaths were reported. There were no differences before/during the pandemic in safety or telemedicine failure metrics within the entire group and high-risk subgroups. CONCLUSIONS: Despite a markedly and rapidly expanded scope of ambulatory telemedicine care during the COVID-19 pandemic, telemedicine remained a safe and high-quality option for pediatric neurology patients. In addition, populations perceived as high risk for telemedicine (the very young, new patients, and those with neuromuscular diagnoses) can benefit from telemedicine visits, particularly when access to in-person care is limited.
Authors: Jaime M Hatcher-Martin; Jamie Lynn Adams; Eric R Anderson; Riley Bove; Tamika M Burrus; Mahan Chehrenama; Mary Dolan O'Brien; Dawn S Eliashiv; Deniz Erten-Lyons; Barbara S Giesser; Lauren R Moo; Pushpa Narayanaswami; Marvin A Rossi; Madhu Soni; Nauman Tariq; Jack W Tsao; Bert B Vargas; Scott A Vota; Scott R Wessels; Hannah Planalp; Raghav Govindarajan Journal: Neurology Date: 2019-12-04 Impact factor: 9.910
Authors: Juan Vazquez; Tanzina Islam; Jonathan Gursky; Jennifer Beller; Daniel Jose Correa Journal: Telemed J E Health Date: 2020-09-30 Impact factor: 3.536
Authors: Salvatore C Rametta; Sara E Fridinger; Alexander K Gonzalez; Julie Xian; Peter D Galer; Michael Kaufman; Marisa S Prelack; Uzma Sharif; Mark P Fitzgerald; Susan E Melamed; Marissa P Malcolm; Sudha Kilaru Kessler; Donna J Stephenson; Brenda L Banwell; Nicholas S Abend; Ingo Helbig Journal: Neurology Date: 2020-06-09 Impact factor: 9.910