An Environmental Scan of Interventions Implemented by Pediatric Health Organizations to Improve Telehealth Equity

Telehealth can improve pediatric access to care; however, substantial telehealth disparities continue to persist. Publications describing the implementation of innovative strategies to improve telehealth equity across pediatric health care organizations are limited. We aimed to describe the degree of implementation of telehealth equity interventions, identify facilitators and barriers to their implementation, and develop a quality improvement framework for future implementation efforts.

We conducted a national survey within the American Academy of Pediatrics' Supporting Pediatric Research on Outcomes and Utilization of Telehealth network from October to December 2023 to obtain an environmental scan of telehealth equity interventions adopted by pediatric health organizations since the onset of the COVID-19 pandemic. We used descriptive statistics to quantify intervention implementation and employed qualitative template analysis of open-ended responses to design a key driver diagram blueprint to advance pediatric telehealth equity.

Of 134 organizations, members from 13 organizations completed the survey, mostly representing large, urban, academic children's hospitals. The most commonly implemented interventions included providing devices or internet access within health care facilities, offering on-demand help desk support, and integrating interpreter services within telehealth visit platforms. In contrast, less commonly implemented interventions included expanding broadband access in community settings, soliciting family visit preferences for telehealth versus in-person visits, and ensuring patient privacy during telehealth encounters.

This study describes the degree of implementation of telehealth equity interventions among well-resourced pediatric health organizations. Our quality improvement framework provides a foundation for future multicenter, collaborative initiatives aimed at reducing telehealth disparities in pediatric populations.