Telemedicine Surge for Pediatric Patients in Response to the COVID-19 Pandemic in New York City

Telemed J E Health. 2021 Oct;27(10):1105-1110. doi: 10.1089/tmj.2020.0413. Epub 2021 Jan 11.

Abstract

Background:Our objective is to describe our pediatric virtual urgent care (VUC) experience at a large urban academic medical center, in response to the COVID-19 pandemic in New York City (NYC).Materials and Methods:We conducted a retrospective cohort study of our pediatric VUC program of patients less than age 18 years, from March 1 to May 31, 2020. We include data on expansion of staffing, patient demographics, virtual care, and outcomes.Results:We rapidly onboarded, educated, and trained pediatric telemedicine providers. We evaluated 406 pediatric patients with median age 4.4 years and 53.9% male. Median call time was 5:12 pm, median time to provider was 5.7 min, and median duration of call was 11.1 min. The most common reasons for a visit were COVID-19-related symptoms (36%), dermatologic (15%), and trauma (10%). Virtual care for patients consisted of conservative management (72%), medication prescription (18%), and referral to an urgent care or pediatric emergency department (PED) (10%). Of 16 patients referred and presented to our emergency department, 2 required intensive care for multisystem inflammatory syndrome in children. Oral antibiotics were prescribed for 7.1% of all patients. Only 0.005% of patients had an unplanned 72-h PED visit resulting in hospitalization after a VUC visit.Conclusion:Pediatric emergency VUC allowed for high-quality efficient medical care for patients during the peak of the COVID-19 pandemic in NYC. Although most patients were managed conservatively in their home, telemedicine also enabled rapid identification of patients who required in-person emergency care.

Keywords: pandemic emergency medicine; pediatrics; telehealth; telemedicine; teletrauma.

MeSH terms

  • Adolescent
  • COVID-19* / complications
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • New York City / epidemiology
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome
  • Telemedicine*

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related