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Telehealth multidisciplinary prenatal consultation during the COVID-19 pandemic: enhancing patient care coordination
Angela Hargis-Villanueva1, Krista Lai1, Kathleen van Leeuwen1,2
1Division of Pediatric Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA.
Insights
Provider satisfaction with telehealth for fetal care consultations was high, with most preferring virtual visits post-pandemic. This rapid shift improved convenience and care coordination for complex prenatal cases.
Area of Science:
- Maternal-Fetal Medicine
- Telehealth in Healthcare
- Congenital Anomaly Management
Background:
- Comprehensive fetal care centers manage congenital anomalies with multidisciplinary pre- and post-natal plans.
- The COVID-19 pandemic necessitated rapid adoption of telehealth services to reduce exposure.
- Centers for Medicare & Medicaid Services (CMS) expanded telehealth access.
Purpose of the Study:
- To assess provider satisfaction with the transition to multidisciplinary telehealth consultations for prenatal care.
- To evaluate telehealth as an adaptive response to pandemic-related restrictions in fetal care.
Main Methods:
- Patients referred during early COVID-19 pandemic underwent advanced fetal imaging.
- Multidisciplinary telehealth consultations were conducted virtually with all providers.
- Provider satisfaction was assessed via an electronic survey.
Main Results:
- 89% of providers reported high satisfaction with the telehealth format.
- 72% preferred telehealth for future visits, citing convenience and improved care coordination.
- Some limitations noted included reduced ability for visual aids and emotional support.
Conclusions:
- Providers strongly support continuing multidisciplinary telehealth for complex prenatal consultations.
- The telehealth model has been continued due to its benefits in convenience and interdisciplinary coordination.
- Further research on patient experiences with virtual consultations is recommended.
Objective:
Comprehensive fetal care centers address congenital anomalies by developing pre- and post-natal care plans in a multidisciplinary format. To reduce exposure during the Coronavirus Infectious Disease-2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services. We assessed provider satisfaction with the rapid transition from in-person prenatal visits to multidisciplinary consultations via telehealth as an adaptive response to the pandemic.
Methods:
Patients referred to an urban academic fetal care center during the first 6 weeks of the COVID-19 pandemic underwent advanced imaging including fetal MRI, focused ultrasound, and fetal echocardiography. Subsequently, multidisciplinary telehealth consultations occurred with all providers attending virtually. Patients were given the option of attending the multidisciplinary telehealth consultation in a conference room in the hospital or from home. During these meetings, relevant images were reviewed with all participants via screen sharing through a secure video platform. Provider satisfaction with the telehealth paradigm was assessed using an electronic survey.
Results:
Twenty-two surveys were administered with a response rate of 82%. 89% of providers were highly satisfied with the telehealth format. 72% of providers would prefer the multidisciplinary telehealth format to an in-person visit for future visits after COVID-19 restrictions are lifted. 22% of providers would leave the choice to the patient's family. One provider preferred in-person visits. Some providers noted that virtual conferences limited the ability to draw pictures, show educational materials, and provide emotional support.
Conclusion:
Providers were overwhelmingly supportive of continuing multidisciplinary telehealth conferences for complex prenatal consultations, even after restrictions are lifted, which has led to the continuation of this model for the duration of the pandemic. Providers highlighted the convenience and improved care coordination across specialties. Further studies to examine the patient experience with virtual consultations are warranted.
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