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

The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.

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

Open access
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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Figure 1 Transition of child neurology outpatient encounters in response to the COVID-19 pandemic COVID-19 = coronavirus disease 2019.
Figure 1 Transition of child neurology outpatient encounters in response to the COVID-19 pandemic COVID-19 = coronavirus disease 2019.CC BY-NC-ND · PubMed Central
Figure 2 Spectrum of diagnoses before and after transition to telehealth in response to the COVID-19 pandemic COVID-19 = coronavirus disease 2019; ICD-10 = International Classification of Diseases, 10th revision.
Figure 2 Spectrum of diagnoses before and after transition to telehealth in response to the COVID-19 pandemic COVID-19 = coronavirus disease 2019; ICD-10 = International Classification of Diseases, 10th revision.CC BY-NC-ND · PubMed Central

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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
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
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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