Nicole W Kittler1, Ilona J Frieden1, Katrina Abuabara1, Dawn H Siegel2, Kimberly A Horii3, Erin F Mathes1, Francine Blei4, Anita N Haggstrom5,6, Jenna L Streicher5,6, Denise W Metry7, Maria C Garzon8,9, Kimberly D Morel8,9, Christine T Lauren8,9, Marcia Hogeling10, Esteban Fernandez Faith11, Eulalia Baselga12, Megha M Tollefson13, Brandon D Newell3, Catherine C McCuaig14, Anthony J Mancini15,16, Sarah L Chamlin15,16, Emily M Becker17, Maria L Cossio18, Sonal D Shah1,19. 1. Department of Dermatology, University of California San Francisco, San Francisco, California, USA. 2. Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. 3. Division of Dermatology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA. 4. Department of Pediatrics/Hematology, Lenox Hill Hospital, Northwell Health, New York, New York, USA. 5. Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA. 6. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA. 7. Department of Dermatology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA. 8. Department of Dermatology, Columbia University, New York, New York, USA. 9. Department of Pediatrics, Columbia University, New York, New York, USA. 10. Division of Dermatology, David Geffen School of Medicine at University of California, Los Angeles, California, USA. 11. Division of Dermatology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA. 12. Hospital Sant Joan de Deu, Barcelona, Spain. 13. Department of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota, USA. 14. Division of Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada. 15. Department of Pediatrics, Feinberg School of Medicine, Northwestern University and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA. 16. Department of Dermatology, Feinberg School of Medicine, Northwestern University and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA. 17. Department of Dermatology, University of Texas Health Science Center-San Antonio, San Antonio, Texas, USA. 18. Department of Dermatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. 19. Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Abstract
BACKGROUND/ OBJECTIVES: The COVID-19 pandemic prompted a rapid expansion in the use of telemedicine. This study aimed to assess the experiences of hemangioma specialists utilizing telemedicine during the COVID-19 pandemic to evaluate and manage infantile hemangiomas (IH), including perceived effectiveness of different modalities and barriers to care delivery. METHODS: Multicenter cross-sectional study asking providers to describe their experiences using telemedicine for initial evaluation of IH from March to September 2020. RESULTS: The study included 281 patients from 15 medical centers internationally. Median time from referral to evaluation was 17 days. Median physician confidence in performing evaluations via telemedicine was 95.0 (IQR 90.0-100.0). Most evaluations were performed via video communication with photographs or audio communication with photographs; when not initially available, photographs were requested in 51.4%. Providers preferred follow-up modalities that included photographs. CONCLUSIONS: Physicians with extensive expertise in managing IH are confident in their abilities to assess and manage IH via telemedicine including initiating treatment in patients without risk factors for beta-blocker therapy. There was a preference for hybrid modalities that included photographs. The data suggest that telemedicine can be effective for managing IH and may decrease wait times and improve specialist reach to underserved areas.
BACKGROUND/ OBJECTIVES: The COVID-19 pandemic prompted a rapid expansion in the use of telemedicine. This study aimed to assess the experiences of hemangioma specialists utilizing telemedicine during the COVID-19 pandemic to evaluate and manage infantile hemangiomas (IH), including perceived effectiveness of different modalities and barriers to care delivery. METHODS: Multicenter cross-sectional study asking providers to describe their experiences using telemedicine for initial evaluation of IH from March to September 2020. RESULTS: The study included 281 patients from 15 medical centers internationally. Median time from referral to evaluation was 17 days. Median physician confidence in performing evaluations via telemedicine was 95.0 (IQR 90.0-100.0). Most evaluations were performed via video communication with photographs or audio communication with photographs; when not initially available, photographs were requested in 51.4%. Providers preferred follow-up modalities that included photographs. CONCLUSIONS: Physicians with extensive expertise in managing IH are confident in their abilities to assess and manage IH via telemedicine including initiating treatment in patients without risk factors for beta-blocker therapy. There was a preference for hybrid modalities that included photographs. The data suggest that telemedicine can be effective for managing IH and may decrease wait times and improve specialist reach to underserved areas.