P1027 - Telemedicine for Routine Follow-up of Post-operative Pediatric Patients

Introduction:
Delivery of healthcare via video-chat (i.e. telemedicine) is growing in interest and applicability and has been shown to increase patient satisfaction. It minimizes travel costs and time expenditure for patients and families and more recently has been widely implemented to prevent the spread of communicable diseases. The aim of this study was to determine if pediatric surgeons could routinely offer telemedicine technologies to patients’ families for post-operative follow-up care.

Methods:
We prospectively identified patients aged 5-18 years old who were scheduled to undergo one of the following surgeries: laparoscopic appendectomy, laparoscopic cholecystectomy, laparoscopic or open inguinal hernia repair, laparoscopic or open ventral hernia repair, abscess incision and drainage, or soft tissue excision. Patients and primary caregivers were seen at their post-operative visit to collect demographic characteristics, health literacy as measured by REALM-SF, and telemedicine related data including access and interest.

Results:
We identified 76 eligible participants, of which 49 enrolled. Of the 27 not enrolled, 55.5% did not show to clinic, 33.3% were unable to be enrolled due to logistical issues (poor weather, visit time changes), and 7.4% declined participation. The majority (52.1%) of enrolled patients were 6-11 years old, and 43.4% were female. Among the 49 primary caregivers, 44.9% were 40-49 years old, and 65.3% were female. Sixty three percent of primary caregivers’ highest level of education was an associates’ degree or higher. The most common procedure was laparoscopic appendectomy (57.9%), followed by open umbilical hernia repair (12.0%). The majority (77.3%) of primary caregivers obtained the highest health literacy score.
Among the primary caregivers, 37.5% stated they experienced challenges getting to clinic, including taking time off work (12.5%), taking their child out of school (12.5%), and distance to travel to clinic (10.4%). The majority of families (69.5%) reported traveling over 20 minutes to get to clinic.
Overall, 46 primary caregivers (93.9%) were interested in using telemedicine. All owned a smartphone and had broadband internet at home, and 95.9% reported video-chat capability. Of the enrolled patients, 93.6% were deemed suitable to follow up via telemedicine after being seen in clinic. Of the five who were deemed not suitable, one was for a clinical concern, two had missing data points, and two were for other concerns.

Conclusions:
Slightly more than one third of families reported difficulty in getting to clinic appointments. Nearly all families were interested in utilizing telemedicine. All families had smartphones and broadband internet access. Providers reported most pediatric patients were suitable for post-operative follow-up via telemedicine for routine surgical procedures. There is an opportunity to institute telemedicine to lower the burden patients face in receiving follow-up care.