Survey of Telemedicine by Pediatric Nephrologists During the COVID-19 Pandemic

Rupesh Raina; Nikhil Nair; Hui Kim Yap; Guido Filler; Sidharth K Sethi; Arvind Bagga; Pankaj Hari; Timothy Bunchman; Sharon Bartosh; Katherine Twombley; Gaurav Kapur; Mignon McCulloch; Bradley A Warady; Maria Díaz-González de Ferris; Sarah Rush

doi:10.1016/j.ekir.2021.06.026

Survey of Telemedicine by Pediatric Nephrologists During the COVID-19 Pandemic

Kidney Int Rep. 2021 Jul 7;6(9):2316-2322. doi: 10.1016/j.ekir.2021.06.026. eCollection 2021 Sep.

Authors

Rupesh Raina^{1

2}, Nikhil Nair³, Hui Kim Yap^{4

5}, Guido Filler⁶, Sidharth K Sethi⁷, Arvind Bagga⁸, Pankaj Hari⁸, Timothy Bunchman⁹, Sharon Bartosh¹⁰, Katherine Twombley¹¹, Gaurav Kapur¹², Mignon McCulloch¹³, Bradley A Warady¹⁴, Maria Díaz-González de Ferris¹⁵, Sarah Rush¹⁶

Affiliations

¹ Akron Nephrology Associates/Cleveland Clinic Akron General and Akron Children's Hospital, Akron, Ohio, USA.
² Department of Nephrology, Akron Children's Hospital, Akron, Ohio, USA.
³ Department of Chemistry, Case Western Reserve University, Cleveland, Ohio, USA.
⁴ Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁵ Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore.
⁶ Departments of Paediatrics, Medicine, and Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.
⁷ Department of Pediatric Nephrology & Pediatric Kidney Transplantation, Kidney and Urology Institute, Medanta, The Medicity Hospital, Gurgaon, India.
⁸ Division of Paediatric Nephrology, All India Institute of Medical Sciences, New Delhi, India.
⁹ Pediatric Nephrology & Transplantation, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, Virginia, USA.
¹⁰ Department of Pediatrics, University of Wisconsin Medical School, Madison, Wisconsin, USA.
¹¹ Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
¹² Pediatric Nephrology and Hypertension, Children's Hospital of Michigan, Detroit, Michigan, USA.
¹³ Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
¹⁴ Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, Missouri, USA.
¹⁵ Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA.
¹⁶ Department of Hematology and Oncology, Akron Children's Hospital, Akron, Ohio, USA.

Abstract

Introduction: The slow increase in use of telemedicine began to expand rapidly, along with reimbursement changes, during the coronavirus disease-2019 (COVID-19) pandemic. Standardized protocols for these services are lacking but are needed for effective and equitable health care. In this study, we queried pediatric nephrologists and their patients about their telemedicine experiences during the pandemic.

Methods: Surveys that were in compliance with the Health Insurance Portability and Accountability Act were deployed online to patients and physicians.

Results: We collected survey responses from 400 patients and 197 pediatric nephrologists. Patients reported positive experiences with telemedicine visits as it was logistically easier than in-person visits. Patients also felt that the quality of their visits were equivalent to what they would receive in person. Physicians used a wide variety of online systems to conduct synchronous telemedicine with Zoom (23%), EPIC (9%), Doxy.me (7%), services not specified (37%), or a mix of local or smaller services (24%). Most physicians' concerns were related to technological issues and the ability to procure physical exams and/or laboratory results.

Conclusions: There is a paucity of published trials on telemedicine services in pediatric nephrology. Virtual care was feasible and acceptable for patients, caregivers, and providers during the COVID-19 pandemic.

Keywords: COVID-19 pandemic; patient experience; patient satisfaction; pediatric nephrology online services; providerexperience; telemedicine.