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Delivering multidisciplinary neuromuscular care for children via telehealth
Kate Carroll1,2,3, Justine Adams1,2, Katy de Valle1,2,4
1Department of Neurology, The Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
The study found that while telehealth maintained clinical activity for neuromuscular clinics during COVID-19, face-to-face interaction was preferred. Most families and clinicians favored a hybrid model combining telehealth and in-person visits for future care.
Area of Science:
- Neurology
- Pediatrics
- Health Informatics
Background:
- The COVID-19 pandemic necessitated a rapid shift from face-to-face (F2F) to telehealth (TH) for multidisciplinary neuromuscular clinics (NMC).
- Understanding patient and clinician experiences with TH is crucial for adapting care models.
Purpose of the Study:
- To evaluate parent, child, and clinician perceptions of TH in a pediatric NMC.
- To analyze changes in clinical activity following the transition to TH.
- To inform the development of a future hybrid care model integrating TH and F2F services.
Main Methods:
- A clinical audit examined activity from 2018-2020.
- Online surveys assessed perceptions of TH among parents, children, and clinicians.
- A working group developed a checklist for a hybrid care model.
Main Results:
- Overall clinical activity was maintained, with 62.8% of appointments conducted via TH in 2020.
- Parents and clinicians reported better interaction in F2F settings but acknowledged TH advantages like reduced stress for parents.
- A lack of hands-on assessment was a key TH limitation.
- A majority of families and all clinicians preferred a future hybrid model of TH and F2F care.
Conclusions:
- The study successfully informed a checklist to guide future TH implementation in a hybrid NMC model.
- Further research is needed to determine the health impacts of TH in pediatric neuromuscular care.
Introduction/Aims:
In response to coronavirus disease 2019 (COVID-19) pandemic restrictions int 2020, our face-to-face (F2F) multidisciplinary neuromuscular clinic (NMC) transitioned to widespread use of telehealth (TH). This study aimed to (1) understand parent/guardian, child, and clinician perceptions of TH; (2) examine TH-related changes in clinical activity; and (3) use these findings to inform a future model of care for the NMC.
Methods:
A clinical audit was undertaken to examine clinical activity throughout 2018-2020. Online surveys were distributed to clinicians and parents of children attending the NMC via TH in 2020. A working group of clinicians created a checklist to guide a future hybrid model of TH and F2F care.
Results:
Total clinical activity in 2020 was maintained from previous years; 62.8% of all appointments occurred via TH, and 82.3% of patients attended NMC by TH at least once. Ninety-nine parents (30.6% response rate), 52 children, and 17 clinicians (77% response rate) responded to the survey. All groups reported better interaction when F2F compared to TH. Eighty percent of parents identified advantages of TH and reported lower levels of stress. A lack of "hands-on" physical assessment was identified by parents and clinicians as a TH limitation. Most families (68.1% of parents; 58.8% of children) and all clinicians indicated a preference for a mix of TH and F2F NMC appointments in the future.
Discussion:
This study has informed a checklist to guide future TH use in a new hybrid model of care. Further investigation is required to assess health impacts of TH use in pediatric neuromuscular care.
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