Study explores the long-term impact of telemedicine on pediatric neurological care



Researchers from the Epilepsy Neurogenetics Initiative (ENGIN) at Children’s Hospital of Philadelphia (CHOP) found that across nearly 50,000 visits, patients continued to use telemedicine effectively even as outpatient clinics reopened a year after the onset of the COVID-19 pandemic. However, notable barriers remain for socially vulnerable families and racial and ethnic minorities, suggesting that more work is required to reach a larger population using telemedicine.

The results, which represent the largest telemedicine study in pediatric neuroscience to date, have been published by the journal Developmental Medicine and Pediatric Neurology.

The COVID-19 pandemic has prompted a rapid and unprecedented transformation of outpatient clinical care from in-person to telehealth visits. While telemedicine was used to provide care to a specific group of adult patients prior to the epidemic, the efficacy of telemedicine in pediatric neuroscience as a new method of care has not been systematically explored. In a previously published study Neurology In 2020, CHOP researchers found that patients and clinicians had a high rate of satisfaction with telemedicine and that many on both sides were interested in using telemedicine for future visits.

To this end, the study team wanted to determine the long-term impact of telemedicine on pediatric neurological care during the COVID-19 pandemic, considering the reopening of outpatient clinics. The observational study was based on a cohort of 34,837 in-person and 14,820 telemedicine outpatient visits between October 2019 and April 2021 across a total of 26,399 neurological patients.

In 2020, the COVID-19 pandemic necessitated the presence of Use of telemedicine visits, but now that telemedicine visits have been established as part of the care we can provide, we have had the opportunity to compare them more comprehensively to in-person visits. With data on nearly 15,000 telemedicine visits, we were able to identify trends in how telemedicine is used by individuals from different demographic backgrounds, neurological conditions and other variables.”


Michael Kaufman, MS, first study author and data scientist with ENGIN at CHOP

The researchers found that telemedicine was a viable option for many patients and was used more often than in-person visits for some patients, such as those with epilepsy and ADHD. Other patients, such as those with certain neuromuscular and movement disorders, younger patients, and those requiring specific procedures were less likely to receive care via telemedicine.

Additionally, the researchers found that self-reported racial and ethnic minorities in the study as well as those with the highest social vulnerability—a measure of a society’s resilience to pressures on human health—were less likely to participate in telemedicine visits. Two new metrics were developed to determine access to telemedicine and track delayed care, revealing further disparities. Some of the most vulnerable individuals were less likely to have activated online patient portals and were more likely to receive delayed care, compared to less vulnerable individuals.

“Our group has studied telemedicine extensively, and our findings show how telemedicine has become a standard component of pediatric neurological care for many patients,” said Ingo Helbig, a pediatric neurologist at CHOP, director of the Center for Genomic and Data Sciences at CHOP. . Epilepsy Neurogenetics Initiative (ENGIN) and senior author of this study. “A public health emergency has arisen over the increased use of telemedicine, and so we need to make sure that, as these new tools for patient care remain prevalent, we continue to recognize and address disparities in care and improve access to socially vulnerable groups so that they have the necessary tools in the event of another similar public health crisis.”

source:

Journal reference:

Kaufman, MC, et al. (2022) Pediatric neurology telemedicine: an analysis of 14,820 patients during the first year of the COVID-19 epidemic. Developmental Medicine and Pediatric Neurology. doi.org/10.1111/dmcn.15406.



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