P1007 - Implementation and Usage of Telemedicine in General Pediatrics During the COVID-19 Pandemic

Problem: With the onset of the COVID-19 pandemic, many public health measures were put into place to decrease the spread of the illness. Initiation of these recommendations resulted in the shutting down of many businesses and the large majority of the public wanting confine at home. Our community noted an increase in patient anxiety about coming into clinic for in-person visits which led to decreased clinic productivity and decreased access to care, as telehealth services were not currently being offered by the general pediatrics department.

Goal: Our general pediatrics clinics rapidly initiated the use of telehealth services via phone and and a video telecommunication platform in order to increase access to care for our patients and promote continued clinical productivity. Our goal was to increase telehealth services to account for at least 25% of total visits over a 6-week period.

Interventions: Telehealth was initiated institution wide after the state of Texas provided relaxed restrictions on services. An initial email was provided by Texas Tech Physicians regarding implementation of telehealth services and was complete with “cheat sheets” for using these services. Our department also created generic email accounts for each clinic to aid in the scheduling of visits. Our resident clinic was also included and the residents were provided with a specific lecture regarding workflow of telehealth visits. One general pediatrics clinic also advertised the new services through a generic phone message and scheduled a meeting with nurses and patient service specialists to address questions and workflow regarding telehealth. The number of telehealth visits by provider and clinic were measured weekly.

Results: After initiation of telehealth, all clinics showed an uptake of this service. All but one provider participated in the use of telehealth. The percentage of total telehealth visits across all clinics peaked at 7.8% the week of 4/6/2020 and then plateaued. The single largest percentage of telehealth visits reached was 12.9 the week of 4/6 by the Pavilion clinic. For the resident clinic, there was an increased use in services after their lecture on telehealth. Continued intervention showed sustaining telehealth visit numbers.

Conclusions: While we were able to quickly initiate telehealth at all of our clinics, the percentage of telehealth visits only reached 7.8% of total. The advertisement of services did not appear to help with patient access as the number of visits scheduled slightly decreased the week the phone message was sent. Creation of the generic email helped with ease in scheduling visits. There still appears to be some barriers to implementation and usage of telehealth services. Continued investigation can look at telehealth use between insurance types and patient location as well as attitudes of patients regarding this service.