Telehealth Improves Access and Efficiency in Pediatric Plastic Surgery: A Study on Surgical Conversion Rates and Time...

Telemedicine has emerged as a transformative tool in modern health care, facilitating remote communication between physicians and patients while improving access, operational efficiency, and cost-effectiveness. Its role has been extensively studied in adult primary care and surgery. However, its application in Pediatric Plastic Surgery remains unexplored. This study evaluates the impact of telehealth at a high-volume Pediatric Plastic Surgery center, assessing its efficacy in expanding access and optimizing patient care pathways.

An IRB-approved retrospective analysis using Salesforce Data Analytics (Salesforce Inc., San Francisco, CA) was conducted on all patients referred to the plastic surgery department at a tertiary pediatric hospital between January 2020 and December 2024. Data collected included referring location, primary diagnosis, and home state. Key outcomes analyzed included referral-to-visit conversion rates, surgical conversion rates, and time to surgery. Comparative analyses were performed between telehealth and in-person consultations, as well as between in-state and out-of-state referrals.

A total of 6369 patients were referred during the study period. The majority (82.5%) resided within 80 miles of the hospital, with 57.3% being in-state and 42.7% out-of-state referrals. The overall referral-to-visit conversion rate was 71%. Among those who underwent consultation, 52.9% proceeded with surgery. Notably, telehealth consultations were associated with a significantly higher surgical conversion rate compared with in-person visits (60.5% versus 47.6%; P <0.001). While consultation rates were comparable between in-state (65.0%) and out-of-state (70.0%) referrals ( P =0.72), out-of-state patients using telehealth had markedly higher surgical conversion rates than those seen in person (70.1% versus 36.9%; P <0.001). In-state patients using telehealth also had significantly higher surgical conversion rates compared with those seen in-person (59.8% versus 36.0%; P <0.001). There was no significant difference in time-to-surgery between the telehealth and the in-person cohorts (167 versus 165 d; P >0.05).

This study underscores the critical role of telehealth in Pediatric Plastic Surgery, particularly in enhancing access for geographically distant patients. Telehealth consultations were associated with higher surgical conversion rates, particularly among out-of-state patients, suggesting that virtual consultations may facilitate more streamlined surgical planning and reduce unnecessary travel burdens. These findings support the broader integration of telehealth into Pediatric Plastic Surgery practice to improve patient access, optimize resource utilization, and expand care delivery for underserved populations.