P1029 - The Before Picture: Assessing the Value of Telemedicine from the Perspective of the Caregiver Presenting to a Pediatric Surgery Clinic Prior to COVID-19

Background: Within pediatrics, the use of telemedicine has grown considerably within the past decade, most notably within primary care and behavioral health. However, within pediatric surgery the increase in use has been modest. In response to COVID-19, many healthcare institutions implemented strategies to curb the spread of the virus, including restricting non-emergent clinic appointments and quickly rolling out telemedicine options for patients. The utility of telemedicine options beyond the COVID-19 restrictive period has not been studied. The purpose of this study is to assess the state of interest in telemedicine for caregivers presenting to a pediatric surgery clinic prior to COVID-19 and to evaluate the potential benefits of continuing telemedicine use within pediatric surgery based on the caregiver perspective.


Methods: Following IRB approval, caregivers for all patients that presented to a general pediatric surgery clinic from January 1, 2020 to March 1, 2020, were considered for enrollment. Subjects were asked to complete a voluntary and anonymous survey. Survey responses were recorded directly into REDCap by participants. Categorical variables were evaluated using frequencies and reported as percentages.

Results: In total, 58 caregivers completed a survey. The majority (51%) of respondents were between 31-40 years old, with 71% identifying as Caucasian and 22% as African American. A fourth (25%) of respondents traveled at least 100 miles, with more than one-third (36%) spending a minimum of 2 hours in travel time. To get to and from the clinic appointment, 69% reported spending at least $10 in fuel, with 13% spending more than $50. Three-quarters (75%) of participants reported working outside of the home, and the majority (53%) had to miss work for the appointment, resulting in missed wages for 41% of respondents. All caregivers had a cellphone and 93% had access to a computer or tablet, with 87% reporting daily internet use and 71% reporting use of video chat at least once per week. Only 26% of respondents were familiar with telemedicine prior to taking the survey. However, following a brief description, 66% responded that they would be interested in remote appointments, with 74% citing cost as a reason and 69% stating that time spent traveling was an important factor. For 91% of respondents the most important factor related to the visit was getting the correct diagnosis.

Conclusion: The COVID-19 restrictive period has led to increased use of telemedicine within pediatric surgery. Prior to COVID-19 most caregivers presenting to a pediatric surgery clinic were unfamiliar with telemedicine options, however, the majority were interested in the benefits afforded by remote evaluation. Future studies are needed to determine how best to continue the use of telemedicine for the treatment of pediatric surgery patients beyond the restrictive period.