Telehealth took off during the COVID-19 pandemic, driven by lockdowns and loosening of regulatory and reimbursement rules that enabled more providers to offer such services. This has been an eye opener for parents, many of whom experienced pediatric telehealth for the first time.
During an October Becker's Hospital Review webinar sponsored by Amwell, Mia Finkelston, MD, medical director at Amwell Medical Group, and Carey Officer, vice president of service delivery innovation at Jacksonville, Fla.-based Nemours Children's Health System, discussed telehealth in pediatric care and how providers can sustain its momentum.
Four insights:
1. Telehealth can improve access to care for families with economic or logistical limitations. In a joint Amwell-Nemours survey of 2,000 parents of children younger than 18, nearly half of respondents had at least one social determinant of health and 43 percent had two or more. The two most common SDoHs were being unable to pay for or get an appointment with a physician. Organizations committed to reinforcing their telehealth offerings can use a SDoH screening approach to help healthcare professionals understand families' barriers to care and preference for in-person versus telehealth care.
"We train our providers before they have their first telehealth visit to hone their observational skills and pay attention to where the patient is calling from. If they´re calling from home, what´s going on in the background? Can you pick up anything about their living environment? Are there other children running around? A question I might have for such a patient is, 'Do you have a way to get to the pharmacy to get your medication?'" Dr. Finkelston said. "We have to communicate with patients and not just assume they can do everything we say. You definitely can pick up on social determinants of health through a telemedicine visit, whether through the phone or computer."
2. Telehealth visits allow for better communication and greater parent involvement in a child's care. As many as 90 percent of parents surveyed said telehealth could help them be more active in their child's care. "For patients, there's something so personal about being on video and having the focus of the providers. And education provided during those visits is such a big component of care," Ms. Officer said.
This effect is even more pronounced in people affected by socioeconomic barriers, who are more likely to use telehealth services post-pandemic for themselves and their child, compared to people not affected by SDoHs, according to the survey.
3. Despite growing interest in telehealth, barriers persist. Seven in 10 survey participants experiencing SDoHs expressed concern about being able to take advantage of telehealth due to a lack of required technology or not being able to understand the healthcare provider. Language barriers can be a deterrent, but some providers are adapting by translating telehealth apps into languages spoken in their community or encouraging patients to bring along an informal translator during visits.
4. Insurance coverage for telehealth visits is essential. Among survey respondents who did not use telehealth, 8 percent said it was because their insurer, provider or employer did not offer it. Further, among non-users, uninsured people outnumbered those who had insurance by 3 percent.
To help overcome these challenges, providers are well positioned to build awareness about the benefits of telehealth and how it works. In parallel, they can advocate at the state and federal level for making permanent the regulatory and reimbursement changes made during the COVID-19 pandemic.
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