Exploring Pediatric Tele-Rheumatology Practices During COVID-19: A Survey of the PRCOIN Network

Frontiers in Pediatrics

Kendra Wiegand¹  Andrew Warmin¹  Cagri Yildirim-Toruner²  Rajdeep Pooni³  Tzielan C. Lee³  Sheetal S. Vora⁴  Julia G. Harris⁵  Nancy Pan⁶  Jon M. Burnham⁷  Janalee Taylor⁸  Esi M. Morgan⁸  Danielle R. Bullock⁹  Fatima Barbar-Smiley^1,10  Y. Ingrid Goh^1,11 

[1] Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States;Department of Rheumatology, Baylor College of Medicine, Houston, TX, United States;Department of Rheumatology, Texas Children's Hospital, Houston, TX, United States;Division of Allergy, Immunology and Rheumatology, Stanford Children's Health, Palo Alto, CA, United States;Division of Pediatric Rheumatology, Atrium Health Levine Children's Hospital, Charlotte, NC, United States;Division of Pediatric Rheumatology, Children's Mercy Kansas City, Kansas City, MO, United States;Division of Pediatric Rheumatology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States;Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States;Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States;Division of Rheumatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States;Division of Rheumatology, Nationwide Children's Hospital, Columbus, OH, United States;Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada;Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada;

关键词: telemedicine;    pediatric rheumatology;    telehealth;    COVID-19;    virtual platform;    digital health (eHealth);    health services research;    virtual care;   

DOI  :  10.3389/fped.2021.642460

来源: Frontiers

【 摘 要 】

Healthcare providers were rapidly forced to modify the way they practiced medicine during the coronavirus disease 2019 (COVID-19) pandemic. Many providers transitioned from seeing their patients in person to virtually using telemedicine platforms with limited training and experience using this medium. In pediatric rheumatology, this was further complicated as musculoskeletal exams typically require hands-on assessment of patients. The objective of this study was to examine the adoption of telemedicine into pediatric rheumatology practices, to assess its benefits and challenges, and to gather opinions on its continued use. A survey was sent to the lead representatives of each Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) site to collect data about their center's experience with telemedicine during the COVID-19 pandemic. Quantitative data were analyzed using descriptive statistics, and qualitative data were thematically analyzed. Responses were received from the majority [19/21 (90%)] of PR-COIN sites. All respondents reported transitioning from in-person to primarily virtual patient visits during the COVID-19 pandemic. All centers reported seeing both new consultations and follow-up patients over telemedicine. Most centers reported using both audio and video conferencing systems to conduct their telemedicine visits. The majority of respondents [13/19 (68%)] indicated that at least 50% of their site's providers consistently used pediatric Gait Arms Legs and Spine (pGALS) to perform active joint count assessments over telemedicine. Over half of the centers [11/19 (58%)] reported collecting patient-reported outcomes (PROs), but the rate of reliably documenting clinical components varied. A few sites [7/19 (37%)] reported performing research-related activity during telemedicine visits. All centers thought that telemedicine visits were able to meet providers' needs and support their continued use when the pandemic ends. Benefits reported with telemedicine visits included convenience and continuity of care for families. Conversely, challenges included limited ability to perform physical exams and varying access to technology. Pediatric rheumatology providers were able to transition to conducting virtual visits during the COVID-19 pandemic. Healthcare providers recognize how telemedicine can enhance their practice, but challenges need to be overcome in order to ensure equitable, sustainable delivery of quality and patient-centered care.

【 授权许可】

CC BY