Background Patients with limited English proficiency (LEP) are at a higher risk of poor health outcomes and are less likely to use telehealth than English-speaking patients. To date, there is no formal evaluation of inpatient (IP) telehealth user experience of patients and their families by language preference during visits with their clinicians. Objective This study aims to compare the experiences of English- and Spanish-speaking patients and their families using IP telehealth, as well as to evaluate the experience of Spanish interpreters providing services through IP telehealth. Methods We prospectively administered a survey to English- and Spanish-speaking patients and their families who used IP telehealth from October 1, 2020, to March 31, 2021. We performed semistructured phone interviews of hospital-based Spanish interpreters who provided services through IP telehealth. Results A total of 661 surveys were administered, with completion rates of 18% (112/621) in English and 62% (25/40) in Spanish. On a 10-point scale, the overall satisfaction of Spanish speakers (median 10, IQR 10-10) was higher than that of English speakers (median 9, IQR 8-10; P=.001). Both English- and Spanish-speaking patients used IP telehealth for visits with their primary IP care team, subspecialty consultants, and other clinicians. Hospital tablets were used more often than personal devices, and only English-speaking patients used personal laptops. Patients and their families encountered challenges with log-in, team coordination with multiple users, and equipment availability. Interpreters encountered challenges with audio and video quality, communication, safety, and Wi-Fi access. Conclusions Both English- and Spanish-speaking patients reported high satisfaction using IP telehealth across multiple disciplines despite the workflow challenges identified by interpreters. Significant investment is needed to provide robust infrastructure to support use by all patients, especially the integration of multiple users to provide interpreter services for patients with LEP.

BACKGROUND AND OBJECTIVES Telehealth visits increased significantly during the coronavirus disease 2019 (COVID-19) pandemic without consensus on the appropriate scope of telehealth antibiotic prescribing within pediatric primary care. We describe telehealth antibiotic prescribing patterns within our statewide pediatric primary care network during the COVID-19 pandemic METHODS In a retrospective observational study of a large statewide pediatric primary care network, we identified and analyzed telehealth and in-person encounters with oral antibiotics prescribed from March 2020 to July 2021. We focused on the top five general diagnosis groupings using International Classification of Disease 10 (ICD-10) codes. RESULTS Of the 55,926 encounters with an oral antibiotic prescribed, 12.5% were conducted via telehealth and 87.5% in person. The proportion of telehealth antibiotic encounters varied significantly according to diagnosis category (P <0.001): ear (30.8%), skin and subcutaneous (21.8%), respiratory (18.8%), genitourinary (6.3%), and Lyme disease infections (3.8%). The proportion of telehealth antibiotic encounters for all diagnosis categories peaked in spring of 2020. The greatest proportion of telehealth antibiotic prescribing during the most recent four weeks of the analysis were Lyme disease infections (11.7%) and for skin and subcutaneous tissue infections (3.1%). CONCLUSIONS Telehealth continues to be used to prescribe antibiotics even after the initial stage of the pandemic. Clinicians and patients would benefit from clearer guidelines about the appropriate use of antibiotics prescribed during telehealth encounters

BACKGROUND Limited English proficient (LEP) patients are at higher risk of poor health outcomes and are less likely to utilize telehealth compared to English speaking patients. There is no formal evaluation of inpatient telehealth user experience by language preference to date. OBJECTIVE To compare the experience of Spanish and English-speaking patients and families using our inpatient telehealth program (ITP). To evaluate the experience of Spanish interpreters using ITP. METHODS We prospectively administered a survey to English and Spanish speaking patients and families who used our ITP from October 1, 2020 to March 31, 2021. We performed semi-structured interviews of hospital based Spanish interpreters by phone who participated in ITP. RESULTS High satisfaction was reported by both English and Spanish speakers (SD 0.47-1.7, IQR 0-2). Both English and Spanish speaking patients participated in ITP with their primary inpatient care team, subspecialty consultants and other clinicians. Hospital tablets were used more often than personal devices, and only English speaking patients utilized a personal laptop. Patients and families encountered challenges with log-in, team coordination with multiple users and equipment availability. Interpreters encountered challenges with audio and visual quality, communication, safety, and Wi-fi access. CONCLUSIONS There is high satisfaction amongst both English and Spanish speaking patients using our ITP. Use cases are multi-disciplinary and suggest lasting applicability post-pandemic, however significant investment is needed to provide robust infrastructure to support utilization by all patients, but especially integration of interpreter services for LEP patients. CLINICALTRIAL N/A