On-Demand, Virtual Health Care During COVID-19: Clinician Redeployment and Telemedicine Utilization in a Children's...

The COVID-19 global pandemic inspired an unprecedented surge in virtual health care. Safety precautions limited in-person urgent care options, despite high patient demand. This study describes how one children's health system redeployed clinical health professionals to expand existing pediatric, urgent care, on-demand telemedicine in the early months of the United States' pandemic response. Patient utilization and visit characteristics during the pandemic are contextualized relative to pre-pandemic, business-as-usual (BAU) operations. This IRB-approved study is a descriptive, retrospective analysis. Key elements of the clinician redeployment process and shift in physician workflow are described. Retrospective data analysis included routine patient and visit characteristics for urgent care, on-demand telemedicine services received January to May 2020. BAU represented telemedicine encounters between January and May 2019. Twenty-eight redeployed pediatricians and advanced practice registered nurses were trained and credentialed to assist the on-demand pediatrician team on the existing telemedicine platform. During 2020, providers completed 5,055 telemedicine visits, a 168% increase over the same timeframe in 2019. Pre-pandemic visit wait time was 6.29 ± 5.4 min, which increased to 23.25 ± 34.30 min during 2020. Top chief complaints included skin-related concerns (27.9%) and upper respiratory infections (20.2%) and were consistent across years. Patient satisfaction with provider and platform were high. By engaging and training redeployed clinicians during the pandemic response, health care access was maintained for thousands of patients. Where regulations allow, clinical health professionals can be trained and redeployed rapidly to on-demand telemedicine platforms to successfully meet spontaneous increases in demand for virtual care.