Flora Howie1, Beth L Kreofsky2, Anupama Ravi3, Troy Lokken4, Mekenzie D Hoff4, Jennifer L Fang5. 1. Division of Developmental and Behavioral Pediatrics, Mayo Clinic, Rochester, Minnesota, USA. 2. Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA. 3. Division of Pediatric Allergy and Immunology, Mayo Clinic, Rochester, Minnesota, USA. 4. Center for Connected Care, Mayo Clinic, Rochester, Minnesota, USA. 5. Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Abstract
Background: Before the COVID-19 pandemic, telemedicine use for outpatient pediatric specialty care was low. Stay-at-home orders (SHO) prompted rapid upscaling of telemedicine capabilities and upskilling of providers. This study compares telemedicine usage before and after the SHO and analyzes how a Children's Center addressed challenges associated with a rapid rise in telemedicine. Methods: Data on outpatient visits across 14 specialty divisions were abstracted from the institutional electronic medical record. The 12-week study period (March 9, 2020-May 29, 2020) spanned three epochs: pre-SHO; post-SHO; reopening to in-person visits. Changes in in-person visits, video visits, and completed, cancelled, and no-show appointments were compared between three epochs. Results: A total of 4,914 outpatient pediatric specialty visits were completed, including 67% (3,296/4,914) in-person and 33% (1,618/4,914) through video. During the first two epochs encompassing the SHO, video visits increased by 4,750%. During the third epoch when the SHO was lifted, video visits decreased by 66%, with 19.4% of visits conducted through video in week 12. Overall, for outpatient video appointments, 82.8% (1,618/1,954) were completed, 9.1% (178/1,954) were cancelled, and 8.1% (158/1,954) were no-shows. The percentage of completed and no-show appointments did not differ between epochs. However, the cancellation rate decreased significantly from Epochs 1 to 3 (p = 0.008). Conclusion: A SHO was associated with a large increase in pediatric specialty video visits. Post-SHO, the percentage of pediatric specialty visits conducted through video decreased but remained higher than before the SHO. Frequent, content-rich communications, self-directed tutorials, and individualized coaching may facilitate successful increases in telemedicine use.
Background: Before the COVID-19 pandemic, telemedicine use for outpatient pediatric specialty care was low. Stay-at-home orders (SHO) prompted rapid upscaling of telemedicine capabilities and upskilling of providers. This study compares telemedicine usage before and after the SHO and analyzes how a Children's Center addressed challenges associated with a rapid rise in telemedicine. Methods: Data on outpatient visits across 14 specialty divisions were abstracted from the institutional electronic medical record. The 12-week study period (March 9, 2020-May 29, 2020) spanned three epochs: pre-SHO; post-SHO; reopening to in-person visits. Changes in in-person visits, video visits, and completed, cancelled, and no-show appointments were compared between three epochs. Results: A total of 4,914 outpatient pediatric specialty visits were completed, including 67% (3,296/4,914) in-person and 33% (1,618/4,914) through video. During the first two epochs encompassing the SHO, video visits increased by 4,750%. During the third epoch when the SHO was lifted, video visits decreased by 66%, with 19.4% of visits conducted through video in week 12. Overall, for outpatient video appointments, 82.8% (1,618/1,954) were completed, 9.1% (178/1,954) were cancelled, and 8.1% (158/1,954) were no-shows. The percentage of completed and no-show appointments did not differ between epochs. However, the cancellation rate decreased significantly from Epochs 1 to 3 (p = 0.008). Conclusion: A SHO was associated with a large increase in pediatric specialty video visits. Post-SHO, the percentage of pediatric specialty visits conducted through video decreased but remained higher than before the SHO. Frequent, content-rich communications, self-directed tutorials, and individualized coaching may facilitate successful increases in telemedicine use.
Authors: Ellen B Goldbloom; Melanie Buba; Maala Bhatt; Sinthuja Suntharalingam; W James King Journal: Paediatr Child Health Date: 2022-09-08 Impact factor: 2.600
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Authors: Lori Uscher-Pines; Colleen McCullough; Michael S Dworsky; Jessica Sousa; Zach Predmore; Kristin Ray; Anthony Magit; Chris Rivanis; Carlos Lerner; Joy Iwakoshi; Steven Barkley; James P Marcin; Troy McGuire; Michael-Anne Browne; Craig Swanson; John Patrick Cleary; Erin Kelly; Katie Layton; Lucy Schulson Journal: JAMA Netw Open Date: 2022-03-01
Authors: Rahul K Patel; Beth L Kreofsky; Katie M Morgan; Amy L Weaver; Jennifer L Fang; Jane E Brumbaugh Journal: J Perinatol Date: 2022-09-10 Impact factor: 3.225