Telemedicine and Health Equity During COVID-19 in Pediatric Gastroenterology.
Jessica Serino-Cipoletta, Catherine Dempsey, Nancy Goldberg and 6 others
PMID 34172354WHAT IT FOUND
78 of 80 parents said pediatric gastroenterology telehealth visits were beneficial, but only 43 said they were as good as an office visit.
Connection failures, interpreter access, and cost barriers were common equity concerns.
Key findings
01Of 80 parent/patient respondents, 78 agreed the telehealth visit was beneficial, but only 43 agreed it was as good as an office visit.
02Provider forms recorded 169 telehealth visits, with patient needs met at the time of visit in 129, outcome pending in 36, and 1 emergent onsite visit needed.
03The team identified connectivity, interpreter access, and financial barriers as health equity concerns and developed a toolkit to address them.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was a single-site pediatric gastroenterology project with only 4 nurse practitioners on the improvement team, so it may not apply to other clinics or disciplines. The parent/patient survey included 80 families and used forms that were not validated. The project did not capture routine follow-up visits that went unscheduled or missed despite being scheduled. The toolkit was developed for further testing and was not tested for whether it improved care. Families were not part of the team that planned this initiative because the project emerged during the pandemic. It did not collect financial data such as comparing family expenses for telehealth visits with in-person visits or reimbursement rates for telehealth versus in-person visits.
The easy way to misread this
Do not conclude that telehealth is equivalent to in-person care or that the toolkit improved equity. This was a single-site quality improvement project with unvalidated forms, and only 43 of 80 parents said the visit was as good as an office visit.