Pre-Coronavirus Disease 2019 Telehealth Practices Among Pediatric Infectious Diseases Specialists in the United States

Abstract

Background Telehealth (TH) practices among pediatric infectious disease specialists prior to the coronavirus disease 2019 (COVID-19) pandemic are largely unknown. Methods In 2019, the Pediatric Infectious Diseases Society (PIDS) Telehealth Working Group surveyed PIDS members to collect data on the use of TH modalities, adoption barriers, interest, extent of curbside consultations (CC), and reimbursement. Results Of 1,213 PIDS members, 161 (13.3%) completed the survey, and the responses of 154 (12.7%) from the US were included in our report. Medical school (63.6%) and hospital (44.8%) were the commonest work settings with 16.9% practicing in both of them. The most common TH modalities used were synchronous provider-patient virtual visits (20.8%) and synchronous provider-provider consultations (13.6%). TH services included outpatient consultations (48.1%), vaccine recommendations (43.5%), inpatient consultations (39.6%) and travel advice (39.6%). Barriers perceived by respondents included reimbursement (55.8%), lack of experience with TH (55.2%), lack of institutional support (52.6%), lack of administrative support (50%), and cost of implementation (48.7%). Most respondents (144, 93.5%) were interested in implementing a wide range of TH modalities. CCs accounted for 1-20 hours/week among 148 respondents. Conclusions Most of the PIDS survey respondents reported low utilization of TH and several perceived barriers to TH adoption before the COVID-19 pandemic. Nonetheless, they expressed a strong interest in adopting different TH modalities. They also reported spending considerable time on non-reimbursed CCs from within and outside their institutions. Results of this survey provide baseline information that will allow comparisons with post-COVID-19 changes in the adoption of TH in PID.

A Narrative Review of Factors Historically Influencing Telehealth Use across Six Medical Specialties in the United States

“…Although earlier studies in the US have paid attention to the wide variation in telehealth use by specialty, the aforementioned study was the first to quantify the variation across medical specialties at the individual provider level. The results of this landmark 2018 study have already been widely referenced in the general telehealth literature, and the evidence has been corroborated in the growing ‘specialty-level’ telehealth literature during the pandemic [ 7 , 8 , 9 , 10 , 11 , 12 ].…”

Analysis of Social Determinants and the Utilization of Pediatric Tele–Urgent Care During the COVID-19 Pandemic: Cross-sectional Study

“…Pediatricians have used telehealth to provide a broad range of health care services among primary and specialty care [1][2][3]. Telehealth is increasingly used to provide specialty consultations to infants and children receiving care [4].…”

Specialty-level Factors Historically Influencing Telehealth Use Can Provide Implications for Sustainability in a Post-Pandemic Era: A Systematic Review and Narrative Synthesis

“…[7] The results of this study have already been widely cited in the general telehealth literature and corroborated by evidence and position statements in the specialty-speci c telehealth literature as well. [10][11][12][13][14][15] The wide variation in telehealth use across medical specialties is intriguing, since the US lacks a nationwide standardized set of telehealth reimbursement policies, which in turn, has historically posed a barrier to telehealth adoption in all specialties. [16] Despite these macro (policy-level) constraints experienced by all medical specialties, some specialties have been able to normalize telehealth to mainstream practice (e.g., Psychiatry, Cardiology); while others are just getting started during the COVID-19 pandemic (e.g., Allergy-Immunology), despite potential for all stakeholders within the specialty (e.g., patients, providers) to bene t from telehealth adoption.…”