Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic

Rametta, Salvatore C.; Fridinger, Sara E.; Gonzalez, Alexander K.; Xian, Julie; Galer, Peter D.; Kaufman, Michael; Prelack, Marisa S.; Sharif, Uzma; Fitzgerald, Mark P.; Melamed, Susan E.; Malcolm, Marissa P.; Kessler, Sudha Kilaru; Stephenson, Donna J.; Banwell, Brenda L.; Abend, Nicholas S.; Helbig, Ingo

doi:10.1212/wnl.0000000000010010

Cited by 129Telemedicine and Telehealth ImplementationCOVID-19 and healthcare impactsDental Research and COVID-19

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Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic

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Rametta, Salvatore C., Fridinger, Sara E., Gonzalez, Alexander K., Xian, Julie, Galer, Peter D., Kaufman, Michael, Prelack, Marisa S., Sharif, Uzma, Fitzgerald, Mark P., Melamed, Susan E., Malcolm, Marissa P., Kessler, Sudha Kilaru, Stephenson, Donna J., Banwell, Brenda L., Abend, Nicholas S., Helbig, Ingo·2020·Neurology

DOI 10.1212/wnl.0000000000010010PMC PMC7538222

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Abstract

OBJECTIVE: To assess the rapid implementation of child neurology telehealth outpatient care with the onset of the coronavirus disease 2019 (COVID-19) pandemic in March 2020. METHODS: This was a cohort study with retrospective comparison of 14,780 in-person encounters and 2,589 telehealth encounters, including 2,093 audio-video telemedicine and 496 scheduled telephone encounters, between October 1, 2019 and April 24, 2020. We compared in-person and telehealth encounters for patient demographics and diagnoses. For audio-video telemedicine encounters, we analyzed questionnaire responses addressing provider experience, follow-up plans, technical quality, need for in-person assessment, and parent/caregiver satisfaction. We performed manual reviews of encounters flagged as concerning by providers. RESULTS: There were no differences in patient age and major ICD-10 codes before and after transition. Clinicians considered telemedicine satisfactory in 93% (1,200 of 1,286) of encounters and suggested telemedicine as a component for follow-up care in 89% (1,144 of 1,286) of encounters. Technical challenges were reported in 40% (519 of 1,314) of encounters. In-person assessment was considered warranted after 5% (65 of 1,285) of encounters. Patients/caregivers indicated interest in telemedicine for future care in 86% (187 of 217) of encounters. Participation in telemedicine encounters compared to telephone encounters was less frequent among patients in racial or ethnic minority groups. CONCLUSIONS: We effectively converted most of our outpatient care to telehealth encounters, including mostly audio-video telemedicine encounters. Providers rated the vast majority of telemedicine encounters to be satisfactory, and only a small proportion of encounters required short-term in-person follow-up. These findings suggest that telemedicine is feasible and effective for a large proportion of child neurology care. Additional strategies are needed to ensure equitable telemedicine use.

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Another challenge of remote consultations stems from infrastructure and device technical issues.
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Child neurology telemedicine: Analyzing 14 820 patient encounters during the first year of the COVID ‐19 pandemic
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Visits of concern in child neurology telemedicine
Prelack, M. S., Fridinger, S. E., Gonzalez, A. K., Kaufman, M. C., Xian, J., Galer, P. D., Craig, S., Abend, N. S., & Helbig, I. (2022) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.15256 · Cited by 12
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Authors: Rametta, S. C., Fridinger, S. E., Gonzalez, A. K., Xian, J., Galer, P. D., Kaufman, M., Prelack, M. S., Sharif, U., Fitzgerald, M. P., Melamed, S. E., Malcolm, M. P., Kessler, S. K., Stephenson, D. J., Banwell, B. L., Abend, N. S., & Helbig, I.
Affiliations: University of Pennsylvania (US)
Corresponding author: Helbig, Ingo
ORCID: Gonzalez, Alexander K.
Xian, Julie
Galer, Peter D.
Kaufman, Michael
Fitzgerald, Mark P.
Kessler, Sudha Kilaru
Banwell, Brenda L.
Abend, Nicholas S.
Helbig, Ingo
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2020-09
Volume: 95
Issue: 9
Pages: e1257-e1266
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.0000000000010010
PMC: PMC7538222
OpenAlex: W3034062233
Cited by: 129
References: 19
Citations by year: 2026: 4 · 2025: 7 · 2024: 11 · 2023: 19 · 2022: 34 · 2021: 44 · 2020: 10
FWCI: 20.06
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
Locations: Neurology (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Funders: Children's Hospital of Philadelphia
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
Keywords: telemedicine, pediatric neurology, COVID-19 pandemic, outpatient care, caregiver satisfaction, racial and ethnic disparities, technical challenges
MeSH terms: COVID-19, Adolescent, Child, Child, Preschool, Female, Humans, Job Satisfaction, Male, Minority Groups, Neurology, Pediatrics, Pneumonia, Viral, Surveys and Questionnaires, Retrospective Studies, Cohort Studies, Caregivers, Patient Satisfaction, Telemedicine, Coronavirus Infections, Pandemics

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Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic

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