The value of telemedicine for the pediatric surgery patient in the time of COVID-19 and beyond

Abstract

Background : Prior to COVID-19, the use of telemedicine within pediatric surgery was uncommon. To curb the spread of the virus many institutions restricted non-emergent clinic appointments, resulting in an increase in telemedicine use. We examined the value of telemedicine for patients presenting to a pediatric surgery clinic before and after COVID-19 Methods Perspectives and the potential value of telemedicine were assessed by surveying patients or caregivers of patients being evaluated by a general pediatric surgeon in-person prior to COVID-19 and by patients or caregivers of patients who completed a telemedicine appointment with a pediatric surgical provider during the COVID-19 period. Results The pre-COVID survey was completed by 57 respondents and the post-COVID survey by 123. Most respondents were white and were caregivers 31-40 years of age. Prior to COVID-19, only 26% were familiar with telemedicine, 25% reported traveling more than 100 miles and >50% traveled more than 40 miles for their appointment. More than 25% estimated additional travel costs of at least $30 and in 43% of households, at least one adult had to miss time from work. Following a telemedicine appointment during the COVID-19 period, 76% reported the care received as excellent, 86% were very satisfied with their care, 87% reported the appointment was less stressful for their child than an in-person appointment, and 57% would choose a telemedicine appointment in the future. Conclusion For families seeking an alternative to the in-person encounter, telemedicine can provide added value over the traditional in-person encounter by reducing the burden of travel without compromising the quality of care. Telemedicine should be viewed as a viable option for pediatric surgery patients and future research directed toward optimizing the experience for patients and providers.

Evaluating the efficacy of virtual prenatal counseling for genitourinary anomalies

“…The aforementioned study from Boston Children's Hospital found that all families attending virtual post-operative pediatric urological visits were "satisfied" or "very satisfied" with their experiences, with 98% reporting that VVs were more convenient than in-person visits (8). High rates of family and provider satisfaction have also been demonstrated in other pediatric surgical fields for a range of virtual medicine types (13)(14)(15)(16). In a recent survey study of 91 high-risk obstetrical patients undergoing VVs for high-risk prenatal care, diabetes mellitus education, genetic counseling, and maternal-fetal medicine (MFM) consultations during the COVID-19 pandemic, Jeganathan et al found that 86.9% of patients reported being satisfied with the care they received, with 78.3% stating that they would recommend telemedicine visits to others (17).…”

Remote treatment of pectus carinatum (Telepectus) during the COVID-19 pandemic

“…surveyed 123 patients or caregivers that used telemedicine for a pediatric surgical appointment demonstrating a satisfaction rate of 86%. [4] By means of quick implementation of telemedicine (telepectus), one month after isolation began, we were able to reset and even sustain the same volume of pectus carinatum consultations as the previous, non-pandemic year. Even more, we were able to reach out to new patients, maintain treatment, and complete it remotely in 16 cases.…”

“…Most of them analyze the potential uses and benefits that would bring to patients in the future and encourage its development. More recently, after the pandemic and a major development in this field, many surveys were done to patients that were attended through this tool showing rates of satisfaction higher than 80% [4].…”

The Development of Telemedicine and eHealth in Surgery during the SARS-CoV-2 Pandemic

“…The global adoption of telemedicine in pediatric surgery has received positive feedback. For instance, two surveys conducted by Metzger et al showed that the adoption of telemedicine services before the pandemic was minimal [32]. Still, the prevalence of telemedicine during the outbreak has made people realize its advantages, such as minimizing stress for children.…”