Parent-Reported Experience With Pediatric Urology Telemedicine Visits During the COVID-19 Pandemic

Abstract

IntroductionTelemedicine has had a slow integration into surgical subspecialties like urology. Little data exists on its effect on urologic patient-provider rapport nor long term clinical outcomes. The purpose of this study was to assess the feasibility and parent-reported experience with telemedicine visits in a tertiary pediatric urology practice during the COVID-19 pandemic.MethodsParents/guardians of pediatric urology patients who were seen via telemedicine between March 12th - October 30th, 2020, at Children’s Hospital Colorado main campus or a satellite campus were contacted within 1 week of their child’s visit and invited to take a telephone survey. A total of 4 yes/no questions and an open-ended question was asked to explore domains of the drawbacks and benefits to telemedicine. Categorical responses and associations between parent demographics and telehealth satisfaction were analyzed with descriptive statistics. Open-ended questions were analyzed using a team-based content analysis approach.ResultsResponse rate was 76.7% (376/490). Median patient age was 4 years. 60.9% (229/376) patients were male, and 39.1% (147/376) patients female. 96.5% of parents felt that all their questions were answered by the end of their appointment. 97.8% of parents felt comfortable using telemedicine for future appointments. Patient sex, age, provider type, insurance type, clinic site, distance from clinic site, and visit diagnosis had no significant impact on survey response. Based on open-ended responses, five general themes emerged: issues with accessing technology, time saving logistics, challenging clinical interactions, a positive overall experience, and parents having about a 50/50 split in preference for telemedicine or in person visits. Multiple parents expressed discomfort with a genital exam via telemedicine.ConclusionsOverall, parents found telemedicine to be an acceptable alternative to in-person visits and demonstrated a willingness to continue to use it in the future. Patient diagnosis and insurance type had no effect on parent response. Parents noted that pediatric urology offers unique challenges due to its personal and sensitive treatment, including the need to evaluate the genitalia. As the role of telemedicine continues to expand, consideration of these challenges is needed to ensure that pediatric urology patients and their parents are comfortable with this approach.

Caregivers’ Satisfaction of Teleconsultations and Associated Factors During COVID-19 Pandemic at Pediatric Clinics of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study

“…22 Furthermore, our finding is lower than previous Indian and American studies that documented that more than 90% of the caregivers were satisfied with the quality of service, convenience, and benefits of teleconsultation in Indian 13 and American settings. 3 It was also quite different from the parents' satisfaction (94.2%) observed with pediatric urology telemedicine in American context 12 and the level (80.5%) reported in Italy. 23 The discrepancies in satisfaction profiles across the different settings can be justified by multiple reasons.…”

“…Moreover, almost all of the teleconsultations carried out in the present study setting were cellphone-based audio calls, unlike that of developed countries, where formal high-end video conferencing systems exist along with the features of store-and-forward of images. 12,13 The difference might also be because our study involved resident physicians who lacked preexisting relationships with patients and their caregivers, while other studies involved primary care providers who had established long-standing rapport with their patients. 18 On the other hand, this study showed that female caregivers were much more likely than men to be satisfied with teleconsultation service.…”

“…9 Recent reports reiterated the fact that teleconsultation provides a considerable alternative to the face-to-face clinical visits in developed countries in general, 10,11 and pediatric population in particular. 12,13 Moreover, it is considered as an effective triage technique to assess patients' complaints, prevent unnecessary clinical visits, and reduce waiting time. 14 Although some government and private health organizations in affluent countries had already established teleconsultation services years ago, the implementation of teleconsultation has not been popular in developing countries such as Ethiopia, particularly in the pre-COVID era.…”