Telemedicine Visits to Children During the Pandemic: Practice-Based Telemedicine Versus Telemedicine-Only Providers |
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| Affiliation: | 1. Department of Pediatrics (KN Ray, SR Wittman, and A Hoberman), University of Pittsburgh School of Medicine, UPMC Children''s Hospital of Pittsburgh, Pittsburgh, Pa;2. Department of Medicine (J Yabes), University of Pittsburgh School of Medicine, Pittsburgh, Pa;3. Department of Health Policy & Management ( L Sabik), University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa;4. Department of Health Care Policy (A Mehrotra), Harvard Medical School, Boston, Mass;1. Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston (AA Nair, RJ Aparasu, M Johnson, and H Chen), Houston, Tex;2. Department of Pharmacy, Texas Children''s Hospital (JL Placencia), Houston, Tex;3. Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children''s Hospital (HJ Farber), Houston, Tex;4. Medical Affairs, Texas Children''s Health Plan (HJ Farber), Houston, Tex;1. Institute for Health Research (MF Daley, LM Reifler, KA Glenn, PJ Cvietusa, JF Steiner), Kaiser Permanente Colorado, Aurora, Colo;2. Department of Pediatrics (MF Daley, SM Arnold Rehring), University of Colorado School of Medicine, Aurora, Colo;3. Department of Asthma (PJ Cvietusa), Allergy and Immunology, Colorado Permanente Medical Group, Denver, Colo;4. Department of Medical Education (JF Steiner, SM Arnold Rehring), Colorado Permanente Medical Group, Denver, Colo;5. Department of Medicine (JF Steiner), University of Colorado School of Medicine, Aurora, Colo;1. Division of General Pediatrics, Boston Children''s Hospital (BM Garrity, A Desmarais, and JG Berry), Boston, Mass;2. Division of General Academic Pediatrics, MassGeneral Hospital for Children (JM Perrin), Boston, Mass;3. Department of Pediatrics, Harvard Medical School (JM Perrin and JG Berry), Boston, Mass;4. Children''s Hospital Association (J Rodean), Lenexa, Kans;5. Department of Physical Medicine & Rehabilitation, University of Pittsburgh (AJ Houtrow), Pittsburgh, Pa;6. School of Medicine, University of Colorado Anschutz Medical Campus (C Shelton and C Stille), Aurora, Colo;7. General Academic Pediatrics, Children''s Hospital Colorado (C Stille), Denver, Colo;8. Health Resources and Services Administration, Maternal and Child Health Bureau (S McLellan), Rockville, Md;9. Family Voices National (C Coleman), Washington, DC;10. Health Resources and Services Administration (M Mann), Rockville, Md;11. Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Harvard Medical School (K Kuhlthau), Boston, Mass;1. Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada;2. Department of Psychiatry (E Wright, S Vigod), Women''s College Hospital, Toronto, ON, Canada;3. Department of Psychiatry (E Wright, S Vigod), University of Toronto, Toronto, ON, Canada;4. Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada;5. SickKids Family Advisory Network (J Rose), The Hospital for Sick Children, Toronto, ON, Canada;6. Department of Pediatrics (E Cohen, J Orkin), University of Toronto, Toronto, ON, Canada;7. Edwin S.H. Leong Centre for Healthy Children (E Cohen), University of Toronto, Toronto, ON, Canada |
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| Abstract: | ObjectiveIn March 2020, regulatory and payment changes allowed “brick and mortar” pediatric practices to offer practice-based telemedicine for the first time, joining direct-to-consumer (DTC) telemedicine vendors in the ability to offer visits for common acute pediatric concerns via telemedicine. We sought to characterize the relative contribution of practice-based telemedicine versus commercial DTC telemedicine models in provision of children's telemedicine from 2018 through 2021.MethodsUsing January 2018 to September 2021 data from Optum's de-identified Clinformatics® Data Mart Database, we identified telemedicine visits by children ≤17, excluding preventive visits and visits to specialists, emergency departments, and urgent care. Among included visits, we defined “telemedicine-only” providers as those with ≥80% of visits via telemedicine and practice-based telemedicine providers as those with ≤50% of visits via telemedicine. We then described the telemedicine visit volume and diagnoses for these categories overall and per 1000 children per month.ResultsFrom January 2018 to February 2020, telemedicine-only providers accounted for 57,815 telemedicine visits (90.8%), while practice-based telemedicine accounted for 4192 telemedicine visits (6.6%). From March 2020 to September 2021, telemedicine-only providers accounted for 38,282 telemedicine visits (6.1%), while practice-based telemedicine accounted for 555,125 telemedicine visits (88.2%). Per month, telemedicine visits to practice-based telemedicine providers increased from pre-pandemic to pandemic periods (0.1 vs 12.9 visits per 1000 children/month), while telemedicine visits to telemedicine-only providers occurred at a similar rate from pre-pandemic to pandemic periods (0.92 vs 0.96 visits per 1000 children/month).ConclusionsWe observed a large increase in telemedicine visits during the pandemic, with the growth in visits exclusively occurring among visits to practice-based telemedicine providers as opposed to telemedicine-only providers. |
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