Transitioning Multidisciplinary Craniofacial Care to Telehealth during the COVID-19 Pandemic: A Single Center Experience

Abstract

Summary: Craniofacial clinics are composed of multidisciplinary teams of providers to deliver coordinated and comprehensive patient care. The coronavirus disease of 2019 (COVID-19) pandemic has disrupted this model, as social distancing guidelines have precluded in-person patient appointments and forced clinics to reconsider their method of care delivery. The University of California, San Francisco, Craniofacial Center has continued to serve patients during this acute period, adopting a hybrid model in which the vast majority of patients are seen through telehealth and a limited number of patients are evaluated in-person. Surveyed patients and families reported high rates of satisfaction, with time savings cited as a particular benefit. Furthermore, most felt comfortable using the video technology required for their appointment. This experience has demonstrated to us that multidisciplinary craniofacial evaluations can be effectively delivered in a telehealth format and has informed our conception of idealized clinic structure. Moving forward, we intend to utilize telehealth visits for selected components of craniofacial evaluations in an effort to maximize efficiency and minimize burden, including addressing barriers to accessing care. Benefits of a hybrid model will include decongestion of clinics and waiting areas, allowing social distancing, addressing clinic space limits, and increased efficiency by eliminating the need for patient and family movement. Demonstration of the safety and efficacy of telehealth visits, combined with regulatory reform that improves reimbursement and allows for appointments across state lines, will be critical for this model to persist beyond the pandemic.

Parental Satisfaction from Telemedicine in the Follow-up of Children Operated for Craniosynostosis during COVID-19 Pandemic

“…9 Prior research by Badiee et al, cited that 87% of the patients and families surveyed somewhat or strongly agreed that they were satisfied with their video visits, and nearly all felt comfortable using the virtual service of the craniofacial center. 10 Results from our online survey produced mostly anticipated outcomes, with 72.3% of parents being overall satisfied, and supported the findings of the previous studies. However, answers from the present survey yielded an unexpected result, also.…”

“… 9 Prior research by Badiee et al, cited that 87% of the patients and families surveyed somewhat or strongly agreed that they were satisfied with their video visits, and nearly all felt comfortable using the virtual service of the craniofacial center. 10 …”

“…Following a similar trend, the previous survey analysis by Badiee et al, depicted that only 26% of patients and parents who were surveyed preferred virtual consultations over in-person meetings, and concluded that the most significant challenge of those who disagreed was the limitation to obtaining a physical examination. 10 …”

Telehealth Adaptation for Multidisciplinary Colorectal Cancer Clinic During the COVID-19 Pandemic

“…The COVID-19 pandemic has forced a shift to virtual format across the full spectrum of healthcare services, and others have described telehealth adaptations for MDT or MDC previously for other clinical contexts aside from colorectal cancer [7][8][9][10][11]. In what is the closest example to the work in this study, Grenda et al reported how the Multidisciplinary Lung Cancer Clinic at the University of Pennsylvania was adapted to a telehealth format [8].…”

Pediatric Plastic Surgery in the COVID-19 Era

“…17 It facilitated remote care, increased geographic access, reduced viral transmission, decreased psychosocial burdens, 18 and lowered patient traffic in clinical settings. 19 Remote practices that used telemedicine also proved to reduce cost, time, and travel strain on patients and their families. 20 Telemedicine also facilitated interprofessional collaboration and dissemination of expertise beyond major medical centers.…”