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National Trends in Pediatric Ambulatory Telehealth Utilization and Follow-Up Care
Naveed Rabbani1,2, Jonathan H Chen3,4
1Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Insights
Telemedicine is common in pediatrics, but some patients, like infants, need in-person follow-up. This research identifies which pediatric telemedicine visits require in-person evaluation for optimal care.
Area of Science:
- Pediatric Healthcare
- Digital Health
- Health Services Research
Background:
- Telemedicine adoption is increasing in pediatric care.
- Optimal utilization requires understanding visit characteristics and follow-up needs.
- Further research is needed to refine telemedicine guidelines.
Purpose of the Study:
- To characterize pediatric telemedicine visits.
- To analyze trends and encounter attributes associated with immediate in-person follow-up.
- To identify patient groups and diagnoses most likely to require in-person evaluation after a telemedicine encounter.
Main Methods:
- Analysis of ambulatory pediatric encounters from a nationwide insurance claims database.
- Data from the first quarter of 2021 were examined.
- Usage trends and encounter attributes were correlated with subsequent in-person visits.
Main Results:
- Telemedicine accounted for 9.5% of ambulatory pediatric encounters.
- 7.5% of telemedicine visits were followed by an in-person visit within 3 days.
- Infants and perinatal diagnoses had higher rates of in-person follow-up (11% and 20%); mental health visits had the lowest.
Conclusions:
- Telemedicine is a significant component of pediatric care.
- Certain patient populations (infants) and conditions (perinatal) necessitate in-person follow-up.
- Findings can guide optimization of pediatric telemedicine and inform guideline development.
Abstract:
As telemedicine becomes standard in pediatrics, further research is required to ensure optimal adoption. This study seeks to characterize visits best suited for telemedicine by analyzing usage trends and encounter attributes associated with immediate in-person follow-up. Analysis of ambulatory pediatric encounters from the first quarter of 2021 in a nationwide insurance claims database. Telemedicine comprised 9.5% (138,346) of ambulatory encounters. Among telemedicine visits, 7.5% (10,304) yielded in-person follow-up within 3 days. Encounters involving infants and diagnoses of the perinatal period were most frequently followed by in-person visits (11% and 20%, respectively). Mental health visits were least likely to have in-person follow-up. In 2021, telemedicine remained a common modality of care in pediatrics. Varying medical needs still require in-person evaluation, whereas other diagnoses may be conducive to even greater expansion. Insights from this study inform further research into optimization of pediatric telemedicine utilization and development of guidelines.
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