Pediatric Telehealth in the COVID-19 Pandemic Era and Beyond

Jul 3, 2021Pediatrics

Using Telehealth for Children's Healthcare During and After the COVID-19 Pandemic

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Telehealth usage has significantly increased due to the COVID-19 pandemic, highlighting both benefits and challenges for patient care.

The pandemic intensified existing weaknesses in the health system that hindered telehealth adoption.
Inequitable access to care and unsustainable costs in a fee-for-service system were exacerbated.
Higher telehealth usage has revealed disparities in how underrepresented patient groups experience virtual care.
Clinical best practices in telehealth have remained unchanged, with a focus on implementing them at scale.
Future assessments are needed to determine which telehealth changes from the pandemic should persist to ensure equitable access for children.

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The coronavirus disease 2019 (COVID-19) pandemic led to an unprecedented demand for health care at a distance, and telehealth (the delivery of patient care using telecommunications technology) became more widespread. Since our 2018 state-of-the-art review assessing the pediatric telehealth landscape, there have been many changes in technology, policy, payment, and physician and patient acceptance of this care model. Clinical best practices in telehealth, on the other hand, have remained unchanged during this time, with the primary difference being the need to implement them at scale.Because of the pandemic, underlying health system weaknesses that have previously challenged telehealth adoption (including inequitable access to care, unsustainable costs in a fee-for-service system, and a lack of quality metrics for novel care delivery modalities) were simultaneously exacerbated. Higher volume use has provided a new appreciation of how patients from underrepresented backgrounds can benefit from or be disadvantaged by the shift toward virtual care. Moving forward, it will be critical to assess which COVID-19 telehealth changes should remain in place or be developed further to ensure children have equitable access to high-quality care.With this review, we aim to (1) depict today's pediatric telehealth practice in an era of digital disruption; (2) describe the people, training, processes, and tools needed for its successful implementation and sustainability; (3) examine health equity implications; and (4) critically review current telehealth policy as well as future policy needs. The American Academy of Pediatrics (AAP) is continuing to develop policy, specific practice tips, training modules, checklists, and other detailed resources, which will be available later in 2021.

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Pediatric Telehealth in the COVID-19 Pandemic Era and Beyond

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