The Impact of Telehealth and Care Coordination on the Number and Type of Clinical Visits for Children With Medical Complexity.

Caregiver response rates differed by group: video 94%, telephone 88%, control 84%, and the authors note higher reporting in the video group could contribute to its higher planned visits. Visits at out-of-system clinics or hospitals may have been missed, especially unplanned local emergency or hospital visits, which could make reductions in unplanned visits look larger. Concurrent clinic quality improvement efforts, aging, possible stabilization of conditions, and seasonal factors could have changed visits independent of the added coordinator. The video group had lower baseline physical function than the telephone and control groups, so the groups were not identical before the intervention. Only 7% of video group encounters used video telehealth, so the video component was not heavily used. Missed or cancelled visits were not tracked, and school-based therapies were excluded from therapy counts. The supplied text does not state which visit measure was the primary outcome.

The TeleFamilies Project was funded by NIH grant R01NR01883 from the National Institute of Nursing Research. The authors declared no conflicts of interest.

Do not conclude that video telehealth nurse coordination reduced unplanned visits or increased planned visits. Unplanned visits decreased in all groups, between-group significance was limited to planned visits, and response rates and concurrent factors could explain the differences.