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Pre-Coronavirus Disease 2019 Telehealth Practices Among Pediatric Infectious Diseases Specialists in the United
Amin Hakim1, Claudia Gaviria-Agudelo2, Kathryn Edwards3
1EMZ Solutions, New York City, New York, USA.
Insights
Pediatric infectious disease specialists used telehealth minimally before COVID-19, facing barriers like reimbursement and lack of support. Despite this, they showed strong interest in adopting more telehealth modalities.
Area of Science:
- Infectious Diseases
- Health Services Research
- Digital Health
Background:
- Telehealth (TH) adoption among pediatric infectious disease (PID) specialists before the COVID-19 pandemic was largely undocumented.
- Understanding pre-pandemic TH practices is crucial for evaluating its evolution.
Purpose of the Study:
- To assess the utilization, barriers, and interest in telehealth among PID specialists prior to the COVID-19 pandemic.
- To establish a baseline for comparing pre- and post-pandemic TH adoption in PID.
Main Methods:
- A survey was distributed in 2019 to members of the Pediatric Infectious Diseases Society (PIDS) by the PIDS Telehealth Working Group.
- Data collected included TH modalities, adoption barriers, interest, curbside consultations (CCs), and reimbursement.
Main Results:
- 154 US-based PID specialists responded, reporting low TH utilization.
- Commonly used TH modalities included synchronous provider-patient and provider-provider virtual visits.
- Key barriers identified were reimbursement issues, lack of experience, and insufficient institutional/administrative support.
Conclusions:
- Pre-pandemic TH adoption in PID was limited, with significant perceived barriers.
- PID specialists expressed a high interest in expanding TH modality implementation.
- Respondents dedicated substantial time to non-reimbursed curbside consultations, highlighting a need for policy changes.
Background:
Telehealth (TH) practices among pediatric infectious disease (PID) specialists prior to the coronavirus disease 2019 (COVID-19) pandemic are largely unknown.
Methods:
In 2019, the Pediatric Infectious Diseases Society (PIDS) Telehealth Working Group surveyed PIDS members to collect data on the use of TH modalities, adoption barriers, interest, extent of curbside consultations (CCs), and reimbursement.
Results:
Of 1213 PIDS members, 161 (13.3%) completed the survey, and the responses of 154 (12.7%) from the United States were included in our report. Medical school (63.6%) and hospital (44.8%) were the commonest work settings with 16.9% practicing in both of them. The most common TH modalities used were synchronous provider-patient virtual visits (20.8%) and synchronous provider-provider consultations (13.6%). TH services included outpatient consultations (48.1%), vaccine recommendations (43.5%), inpatient consultations (39.6%), and travel advice (39.6%). Barriers perceived by respondents included reimbursement (55.8%), lack of experience with TH (55.2%), lack of institutional support (52.6%), lack of administrative support (50%), and cost of implementation (48.7%). Most of the respondents (144, 93.5%) were interested in implementing a wide range of TH modalities. CCs accounted for 1-20 hours/week among 148 respondents.
Conclusions:
Most of the PIDS survey respondents reported low utilization of TH and several perceived barriers to TH adoption before the COVID-19 pandemic. Nonetheless, they expressed a strong interest in adopting different TH modalities. They also reported spending considerable time on non-reimbursed CCs from within and outside their institutions. The results of this survey provide baseline information that will allow comparisons with post-COVID-19 changes in the adoption of TH in PID.
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