Related Experiment Video
Updated: Aug 21, 2025
Bridging the Technology Divide in the COVID-19 Era: Using Virtual Outreach to Expose Middle and High School Students to Imaging Technology
Published on: September 28, 2022
Preoperative Hospitalist Telehealth Visits for Medically Complex Children During the COVID-19 Pandemic
Hayley Goldner1,2, Sahar Barfchin1,2, Emily K Fingado1,2
1General Academic Pediatrics, Nemours Children's Health, Wilmington, Delaware.
Insights
Preoperative telehealth visits are practical for medically complex children, showing no significant differences in outcomes compared to in-person visits. This approach offers a viable alternative for pediatric surgical care.
Area of Science:
- Pediatric Surgery
- Health Services Research
- Telemedicine
Background:
- The coronavirus disease 2019 (COVID-19) pandemic accelerated the adoption of telehealth as an alternative to in-person medical consultations.
- Preoperative evaluations for medically complex pediatric patients undergoing elective orthopedic surgery traditionally involve in-person hospitalist visits.
- Limited data exist on the efficacy and practicality of preoperative telehealth for this specific patient population.
Approach:
- A retrospective study was conducted comparing 68 preoperative visits (34 telehealth, 34 in-person) for medically complex children scheduled for orthopedic surgery between April and October 2020.
- Demographic data, clinical characteristics, visit outcomes, and hospitalist recommendations were collected and analyzed.
- Statistical comparisons were made between patients who received telehealth versus in-person preoperative evaluations.
Key Points:
- No statistically significant differences were observed in telehealth utilization based on primary language, insurance type, medical condition, or functional status (Gross Motor Function Classification System score).
- Technology dependence did not significantly impact the use of telehealth services.
- The number of hospitalist recommendations (4 vs. 3) and progression to surgery (32 vs. 32) were comparable between telehealth and in-person groups.
Conclusions:
- Preoperative telehealth is a practical and effective modality for evaluating medically complex pediatric patients before orthopedic surgery.
- The study found no disparities in access or outcomes related to technology dependence, suggesting broad applicability.
- Further research with a wider scope is recommended to explore the full potential of preoperative telehealth services.
Background:
During the coronavirus disease 2019 pandemic, telehealth has emerged as an alternative to in-person visits. Our children's hospital's preoperative program includes a pediatric hospitalist evaluation of medically complex patients undergoing elective orthopedic surgery. Starting in March 2020, patients were offered either in-person or telehealth preoperative visits. Few data exist regarding preoperative telehealth for medically complex children. We sought to assess this program's practicality and compare clinical characteristics, demographic data, and visit outcome data of patients seen via telehealth versus those seen in person.
Methods:
We retrospectively collected demographic or clinical data, visit characteristics, and visit outcome data of medically complex children scheduled for orthopedic surgery seen April-October 2020. We reviewed the data to compare characteristics of patients seen in person to those seen via telehealth.
Results:
We reviewed 68 visits: 34 (50%) telehealth and 34 (50%) in-person. There was no statistically significant difference in telehealth use by primary language, insurance type, underlying medical condition, gross motor function classification system score, or technology dependence. There was no significant difference between the median number of hospitalist recommendations (4 telehealth vs 3 in-person, P = .553) or progression to surgery (32 vs 32, odds ratio 1.000, confidence interval 0.133-7.540) on the basis of visit type.
Conclusions:
A preoperative telehealth program is practical for medically complex children. We found no significant difference in telehealth use between technology-dependent patients and those who are not. Further study of preoperative telehealth visits will hopefully be broader in scope.
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:30Current Trends in Nursing II
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Hospitals-I