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Virtual care in the pediatric emergency department: a new way of doing business?
Sarah Reid1,2, Maala Bhatt3,4, Roger Zemek5,3
1Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, Canada. sreid@cheo.on.ca.
Insights
The first Virtual Pediatric Emergency Department (V-PED) in Canada is feasible and highly satisfactory for caregivers. This virtual care model effectively reduces the need for in-person emergency department visits.
Area of Science:
- Pediatric Emergency Medicine
- Digital Health
- Healthcare Delivery Innovation
Background:
- Virtual care models are emerging as adjuncts to traditional emergency services.
- Tertiary pediatric hospitals face increasing demands on emergency departments.
- Assessing the feasibility and impact of novel virtual care solutions is crucial.
Purpose of the Study:
- To evaluate the feasibility, utilization, and caregiver satisfaction of Canada's first Virtual Pediatric Emergency Department (V-PED).
- To determine the impact of V-PED on hospital admission rates and the need for in-person emergency department (ED) assessment.
- To explore the potential of virtual care to alleviate the burden on traditional pediatric EDs.
Main Methods:
- A prospective cohort study was conducted from May to July 2020.
- Included children (<18 years) from Ontario and Quebec seeking V-PED care via a secure video platform.
- Caregiver-determined appropriateness through an online triage questionnaire; outcomes included V-PED visits, admissions, and satisfaction surveys.
Main Results:
- 1036 V-PED visits were recorded; 17.0% were referred for in-person ED assessment, and 0.8% required hospital admission.
- Of 107 survey respondents, 87% rated overall satisfaction as excellent (9-10/10).
- 69% of respondents indicated they would have sought in-person ED care if V-PED was unavailable.
Conclusions:
- The novel V-PED is feasible, demonstrates high caregiver satisfaction, and can effectively reduce in-person ED visits.
- Ensuring the safety of emergency virtual care is paramount for future development.
- Further research should focus on increasing V-PED capacity and integration within conventional emergency medicine.
Objectives:
To understand the feasibility, utilization rate, and satisfaction of the first Virtual Pediatric ED (V-PED) in Canada.
Methods:
We conducted a prospective cohort study examining the feasibility and impact of virtual care as an adjunct to in-person emergency care at a tertiary pediatric hospital from May to July 2020. Children (< 18 years) from Ontario and Quebec seeking V-PED care were included. A secure, encrypted, video platform within the hospital's electronic medical record was used. Caregivers self-determined appropriateness of V-PED using a standardized online triage questionnaire to request their appointment. The V-PED is directly launched from the patient's chart and the family joins the portal via hyperlink. Outcome measures included the number of V-PED visits, hospital admission rates, and caregiver satisfaction using a 10-item voluntary post-visit online survey.
Results:
A total of 1036 V-PED visits were seen of which 176 (17.0%) were referred for further in-person ED assessment, and 8 (0.8%) required hospital admission. Of the 107 completing patient experience surveys (10% response), most respondents (69%) endorsed they "very likely" or "definitely" would have presented in-person to the ED if V-PED were unavailable. Overall satisfaction was rated as excellent (9 or 10 out of 10) in 87% of respondents.
Conclusion:
Our novel V-PED is feasible, has high caregiver satisfaction, and can reduce the burden of in-person ED visits. Future work must ensure the safety of emergency virtual care and examine how to increase capacity and integrate V-PED within traditional emergency medicine.
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