Pediatric Subspecialty Adoption of Telemedicine Amidst the COVID-19 Pandemic: An Early Descriptive Analysis

James Xie; Priya Prahalad; Tzielan C Lee; Lindsay A Stevens; Kara D Meister

doi:10.3389/fped.2021.648631

Pediatric Subspecialty Adoption of Telemedicine Amidst the COVID-19 Pandemic: An Early Descriptive Analysis

Front Pediatr. 2021 Apr 13:9:648631. doi: 10.3389/fped.2021.648631. eCollection 2021.

Authors

James Xie^{1

2}, Priya Prahalad^{2

3}, Tzielan C Lee^{2

4}, Lindsay A Stevens^{2

5}, Kara D Meister⁶

Affiliations

¹ Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Lucile Packard Children's Hospital-Stanford Children's Health, Stanford University School of Medicine, Stanford, CA, United States.
² Information Services Department, Stanford Children's Health, Stanford, CA, United States.
³ Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Lucile Packard Children's Hospital-Stanford Children's Health, Stanford University School of Medicine, Stanford, CA, United States.
⁴ Division of Pediatric Rheumatology, Department of Pediatrics, Lucile Packard Children's Hospital-Stanford Children's Health, Stanford University School of Medicine, Stanford, CA, United States.
⁵ Division of General Pediatrics, Department of Pediatrics, Lucile Packard Children's Hospital-Stanford Children's Health, Stanford University School of Medicine, Stanford, CA, United States.
⁶ Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Lucile Packard Children's Hospital-Stanford Children's Health, Stanford University School of Medicine, Stanford, CA, United States.

Abstract

Telemedicine has rapidly expanded in many aspects of pediatric care as a result of the COVID-19 pandemic. However, little is known about what factors may make pediatric subspeciality care more apt to long-term adoption of telemedicine. To better delineate the potential patient, provider, and subspecialty factors which may influence subspecialty adoption of telemedicine, we reviewed our institutional experience. The top 36 pediatric subspecialties at Stanford Children's Health were classified into high telemedicine adopters, low telemedicine adopters, and telemedicine reverters. Distance from the patient's home, primary language, insurance type, institutional factors such as wait times, and subspecialty-specific clinical differences correlated with differing patterns of telemedicine adoption. With greater awareness of these factors, institutions and providers can better guide patients in determining which care may be best suited for telemedicine and develop sustainable long-term telemedicine programming.

Keywords: COVID-19; access; pediatric; subspecialty; telehealth; telemedicine.