Telemedicine journal and e-health : the official journal of the American Telemedicine Association最新文献

{"title":"e-Health for COVID-19 Epidemic: The Arizona Poison and Drug Information Center Experience.","authors":"Stephen A Klotz,&nbsp;Mary L Miller,&nbsp;Kirsten M Pogreba-Brown,&nbsp;Kenneth K Komatsu,&nbsp;Laura M Morehouse,&nbsp;Steven W Dudley,&nbsp;F Mazda Shirazi","doi":"10.1089/tmj.2021.0287","DOIUrl":"https://doi.org/10.1089/tmj.2021.0287","url":null,"abstract":"<p><p>\u0000 <b>\u0000 <i>Background:</i>\u0000 </b>\u0000 <i>A significant challenge of the COVID-19 epidemic was the dissemination of accurate and timely information to the public, health care providers, and first responders. We describe the expansion of the Arizona Poison and Drug Information Center (APDIC) to fill such a need for residents of Arizona.</i>\u0000 <b>\u0000 <i>Methodology:</i>\u0000 </b>\u0000 <i>The original mission of the APDIC was recognition and management of chemical exposure, poisoning, envenomation, and drug-related medical problems. In response to COVID-19, APDIC expanded its personnel and facilities to accommodate telephone calls and teleconsults regarding COVID-19. Thirteen different topics dealing with COVID-19 were addressed and tracked and included: testing information, isolation, prevention, personal protective equipment, travel, vaccines, therapies, antibody testing, contact tracing, exposure to the virus and what to do in businesses, at work or at school regarding isolation and quarantine.</i>\u0000 <b>\u0000 <i>Results:</i>\u0000 </b>\u0000 <i>Responding to the public health needs, APDIC accepted >320,000 telephone calls and completed 48,346 teleconsults from March 3, 2020 to March 3, 2021. This represented a 15-fold increase in calls and twice the number of consults over 2019. Upon release of the vaccine, calls increased sharply with >7,000 calls in 1 day (February 7, 2021).</i>\u0000 <b>\u0000 <i>Conclusion:</i>\u0000 </b>\u0000 <i>In conclusion, the APDIC, rapidly expanded to address urgent public health information needs surrounding COVID-19 while still accomplishing its founding mission.</i>\u0000 </p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"747-751"},"PeriodicalIF":4.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39435362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Health Information Technology in Pneumococcal Vaccination Uptake Among Adults with Heart Disease.","authors":"Onoriode Kesiena,&nbsp;Joseph Atarere,&nbsp;Shreyas Singireddy,&nbsp;Ademayowa Ademiluyi,&nbsp;Oluwaseun Famojuro","doi":"10.1089/tmj.2021.0333","DOIUrl":"https://doi.org/10.1089/tmj.2021.0333","url":null,"abstract":"<p><p><b><i>Background:</i></b><i>Health information technology (HIT) may influence pneumococcal vaccination uptake in high-risk populations. This study assessed the association of HIT utilization on pneumococcal vaccine (PCV) uptake among adults ≥40 years with heart disease.</i><b><i>Methods:</i></b><i>This was a cross-sectional study of 2,134 individuals representing 16,813,593 United States adults ≥40 years with heart disease using the National Health Interview Survey data. The independent variables were use of the Internet to (1) look up health information, (2) fill a prescription, and (3) schedule a medical appointment, and use of an e-mail (4) communicate with a health care provider. The dependent variable was PCV uptake. Chi-square analysis was used to evaluate group differences, and a multiple logistic regression was used to analyze the association between HIT utilization and PCV uptake.</i><b><i>Results:</i></b><i>Those who use the Internet to fill up a prescription and to communicate with their health care provider were more likely to take up the PCV (adjusted odds ratio [AOR] 1.56; 95% confidence interval [CI] 1.03-2.37,</i> p<i> = 0.035) and (AOR 1.95; 95% CI 1.23-3.10,</i> p<i> = 0.005) respectively. Compared with those who did not use HIT in any form, those who used HIT in at least three or four forms had a higher PCV uptake (AORs 1.93; 95% CI 1.19-3.13,</i> p<i> = 0.008) and (AOR 2.33 95% CI 1.22-4.47,</i> p<i> = 0.011) respectively.</i><b><i>Conclusion:</i></b><i>Our analysis shows a positive association of HIT utilization and PCV uptake. It further stresses the importance of electronic health in preventive medicine. This implies that HIT can be used purposively in other aspects of preventive health. Larger studies should evaluate the relationship between different uses of HIT and the uptake of different vaccines.</i></p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"699-705"},"PeriodicalIF":4.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39430261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Satisfaction of the Use of Telehealth and Access to Care for Veterans During the COVID-19 Pandemic.","authors":"Sara Kintzle,&nbsp;Wilmer A Rivas,&nbsp;Carl A Castro","doi":"10.1089/tmj.2021.0262","DOIUrl":"https://doi.org/10.1089/tmj.2021.0262","url":null,"abstract":"<p><p>\u0000 <b>\u0000 <i>Background:</i>\u0000 </b>\u0000 <i>While many health care providers have shifted toward telehealth services in response to the COVID-19 pandemic, little is known about the perception and acceptance of such services, particularly among vulnerable populations. Veterans, who are at increased risk of physical and mental health needs, may benefit from the use and availability of telehealth services.</i>\u0000 <b>\u0000 <i>Materials and Methods:</i>\u0000 </b>\u0000 <i>Cross sectional survey data related to telehealth use, satisfaction, and access were collected through an online survey. Participants from previous research studies and veterans receiving care at a national veteran behavioral health organization were invited to participate.</i>\u0000 <b>\u0000 <i>Results:</i>\u0000 </b>\u0000 <i>A total of 404 veterans participated. Before the pandemic, many veterans had never used telehealth for physical (72%) or mental (76%) health care. Since the start of the pandemic, 62% of participants reported they received some care through telehealth services. Most participants found telehealth valuable and helpful (82%), indicated the technology was well explained (77%), and felt that issues were resolved quickly and easily (67%). Access to care was limited among participants who utilize massage therapy (64%), dental care (53%), routine checkups (50%), acupuncture (50%), and physical therapy (48%).</i>\u0000 <b>\u0000 <i>Discussion:</i>\u0000 </b>\u0000 <i>These findings showed an increase in the use of telehealth services and overwhelming satisfaction among veterans. Despite this, some veterans indicated barriers to receiving physical and mental health care.</i>\u0000 <b>\u0000 <i>Conclusions:</i>\u0000 </b>\u0000 <i>This provides an opportunity to expand the use of telehealth services to meet the health care needs of veterans. Barriers to care should be addressed to minimize the impact on the well-being of veterans.</i>\u0000 </p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"706-711"},"PeriodicalIF":4.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39439146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Telemedicine Use for Chronic Disease Specialty Care in the Alaska Tribal Health System, 2015-2019.","authors":"Elizabeth D Ferucci,&nbsp;Rabecca I Arnold,&nbsp;Peter Holck","doi":"10.1089/tmj.2021.0131","DOIUrl":"https://doi.org/10.1089/tmj.2021.0131","url":null,"abstract":"Background: There are disparities in access to specialty care for chronic diseases in rural and minority populations. Telemedicine has been proposed to improve access. Introduction: The objective of this study was to identify predictors of telemedicine use for chronic disease specialty care in the Alaska Tribal Health System (ATHS) in the setting of usual care. Materials and Methods: We utilized data from the electronic health record (EHR) of patients from four regions in the ATHS. We queried the EHR to identify cases (ever users of telemedicine) and controls (never users), both of whom had chronic diseases requiring specialty care. Data were collected from 2015 through mid-2019. Results: We included 3,075 patients (799 ever users and 2,276 never users). In univariate analysis, ever users were older, more likely to be male, had more chronic conditions and higher encounter rates. There were differences by region, community, and type of specialty clinic. In our simple multivariate model, factors associated with telemedicine use included age, male gender, region, and outpatient visit rate per year. Having at least one cardiology clinic visit was also associated with telemedicine use, with the highest estimated odds ratio (5.27, p < 0.01). Discussion: This study describes factors associated with telemedicine use in the ATHS before the COVID-19 pandemic. We anticipate monitoring changes in these predictors over time, as we expect them to evolve. Conclusions: We found among factors associated with telemedicine use were age, gender, region, outpatient visit rate, and visits to a specific specialty clinic.","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"682-689"},"PeriodicalIF":4.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39411472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Clinical Practice Guide for Occupational Therapy, Physical Therapy, and Speech and Language Pathology: A Saudi and Middle Eastern Guide.","authors":"Bazah M Almubark,&nbsp;Nabat Majrashi,&nbsp;Norah Alghusun,&nbsp;Mohammed Alhammad,&nbsp;Faisal Alhthifi,&nbsp;Reem S W Alyahya","doi":"10.1089/tmj.2021.0021","DOIUrl":"https://doi.org/10.1089/tmj.2021.0021","url":null,"abstract":"<p><p>Telehealth refers to the application of telecommunications technology to deliver clinical services at a distance by linking clinician to patient, caregiver, or any person(s) involved in client care for assessment, intervention, consultation, and supervision. Telehealth for occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) have produced service delivery venues that are of great benefit during the coronavirus disease 2019 pandemic. The concept of telehealth for rehabilitation services is relatively new in the Middle East, and no specialty-specific clinical practice standards or guidelines are published to guide the rehabilitation practitioners. Therefore, a specialty-specific telehealth practice guide for rehabilitation practitioners has been developed by an expert panel in the field of rehabilitation. This guide is documented in this article. Such a guide will be beneficial when providing tele-evaluation, teleintervention/telerehabilitation, teleconsultation, and telemonitoring through communication technologies. The purpose of this guide is to enable understanding of core telehealth clinical principles and aid the provision of OT, PT, and SLP telehealth services in Saudi Arabia. Also, the guide can potentially be implemented in other Middle Eastern countries. The guide is based on key telehealth guidelines involving the American Occupational Therapy Association telehealth resources, American Physical Therapy Association, American Speech and Hearing Association, telemedicine policies in Saudi Arabia by the national health information center at the Saudi Health Council, and a blueprint for telerehabilitation guidelines that are based on the American Telemedicine Association's Core Standards for Telemedicine Operations.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"636-642"},"PeriodicalIF":4.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39421930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Patient-Provider Secure Message Content and Patients' Health Care Visits.","authors":"Dawn Heisey-Grove,&nbsp;Laura E McClelland,&nbsp;Cheryl Rathert,&nbsp;Kevin Jackson,&nbsp;Jonathan DeShazo","doi":"10.1089/tmj.2021.0164","DOIUrl":"https://doi.org/10.1089/tmj.2021.0164","url":null,"abstract":"<p><p><b><i>Background:</i></b><i>Between-visit communications can play a vital role in improving intermediate patient outcomes such as access to care and satisfaction. Secure messaging is a growing modality for these communications, but research is limited about the influence of message content on those intermediate outcomes. We examined associations between secure message content and patients' number of health care visits.</i><b><i>Methods:</i></b><i>Our study included 2,111 adult patients with hypertension and/or diabetes and 18,309 patient- and staff-generated messages. We estimated incident rate ratios (IRRs) for associations between taxonomic codes assigned to message content, and the number of office, emergency department, and inpatient visits.</i><b><i>Results:</i></b><i>Patients who initiated message threads in 2017 had higher numbers of outpatient visits (</i>p<i> < 0.001) compared with patients who did not initiate threads. Among patients who initiated threads, we identified an inverse relationship between outpatient visits and preventive care scheduling requests (IRR = 0.92; 95% confidence interval [CI]: 0.86-0.98) and requests for appointments for new conditions (IRR = 0.95; 95% CI: 0.92-0.99). Patients with higher proportions of request denials or more follow-up appointment requests had more emergency department visits compared with patients who received or sent other content (IRR = 1.18; 95% CI: 1.03-1.34 and IRR = 1.14; 95% CI: 1.07-1.23, respectively). We identified a positive association between outpatient visits and the proportion of threads that lacked a clinic response (IRR = 1.02; 95% CI: 1.00-1.03).</i><b><i>Discussion:</i></b><i>We report on the first analyses to examine associations between message content and health care visits.</i><b><i>Conclusions:</i></b><i>Our findings are relevant to understanding how to better use secure messaging to support patients and their care.</i></p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"690-698"},"PeriodicalIF":4.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39453361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Veterans Hospital Administration Telehealth Utilization for Recreation and Creative Arts Therapies: A Brief Report.","authors":"Kristin M Story,&nbsp;Mindy E Flanagan,&nbsp;Heather A Brown,&nbsp;Sheri L Robb,&nbsp;Teresa M Damush,&nbsp;David Otto","doi":"10.1089/tmj.2021.0363","DOIUrl":"https://doi.org/10.1089/tmj.2021.0363","url":null,"abstract":"<p><p>\u0000 <b>\u0000 <i>Background:</i>\u0000 </b>\u0000 <i>A brief query was fielded to Veterans Health Administration (VHA) facilities across the United States to provide an initial assessment of recreation therapy (RT) and creative arts therapy (CAT) telehealth utilization.</i>\u0000 <b>\u0000 <i>Methods:</i>\u0000 </b>\u0000 <i>To develop an understanding of barriers and identify potential solutions for better delivery of services, a cross-sectional survey was deployed to points of contact at 136 VHA facilities. The survey included questions across five areas: staff, infrastructure, barriers to use, training, and interventions being deployed. Descriptive statistics were calculated, and a thematic analysis of qualitative responses was conducted.</i>\u0000 <b>\u0000 <i>Results:</i>\u0000 </b>\u0000 <i>The most frequent themes from aggregated responses indicated a need for hands-on training, reliable telehealth equipment, and accessible training and tools for Veteran patients who want to use telehealth services.</i>\u0000 <b>\u0000 <i>Conclusion:</i>\u0000 </b>\u0000 <i>Telehealth delivery of RT/CAT has increased services to Veteran patient populations; however, equipment and training are needed to expand consistent delivery to enhance patient reach across a national health care system.</i>\u0000 </p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"752-757"},"PeriodicalIF":4.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c9/e9/tmj.2021.0363.PMC9127826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39342692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Considerations in Ensuring a Safe Regional Telehealth Care Model: A Systematic Review.","authors":"Siggy Haveland, Shahidul Islam","doi":"10.1089/tmj.2020.0580","DOIUrl":"10.1089/tmj.2020.0580","url":null,"abstract":"<p><p>\u0000 <b>\u0000 <i>Background:</i>\u0000 </b>\u0000 <i>This literature review sets out to increase the knowledge on patient safety within the telehealth modality of care, to inform the relevant local health service departments on the key considerations to minimize patient harm.</i>\u0000 <b>\u0000 <i>Methods:</i>\u0000 </b>\u0000 <i>A systematic search in Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, and the University of New England (UNE) Library Search was conducted. A combination of key terms \"Telehealth\" OR \"Telecare\" OR \"Telemedicine\" AND \"patient safety\" AND \"rural\" was used. Based on the screening and eligibility criteria, 21 peer-reviewed articles published in English between 2015 and 2020 were included in the review.</i>\u0000 <b>\u0000 <i>Results and Discussion:</i>\u0000 </b>\u0000 <i>On evaluating the included studies, three main themes and various corresponding subthemes emerged. The main themes were that of telehealth experience (TE), telehealth outcomes (TO), and telehealth risks (TR), with the corresponding subthemes of telehealth experience from a patient perspective (TE-PT), telehealth experience from a carer perspective (TE-CR), telehealth experience from a clinician perspective (TE-CN), positive telehealth (TO-P), and negative telehealth outcomes (TO-N), and patient (TR-PT) and clinician telehealth risks (TR-CN).</i>\u0000 <b>\u0000 <i>Conclusions:</i>\u0000 </b>\u0000 <i>The results suggest that patients generally have positive experiences and are accepting telehealth as a modality of care. Furthermore, patient outcomes appear to be comparable with in-person care, with additional benefits of lower costs to both the service and patients.</i>\u0000 </p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"602-612"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38956165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compliance with Telemonitoring in Heart Failure. Are Study Findings Representative of Reality?: A Narrative Literature Review.","authors":"Rhiannon Berry,&nbsp;Philip Keeling","doi":"10.1089/tmj.2021.0225","DOIUrl":"https://doi.org/10.1089/tmj.2021.0225","url":null,"abstract":"Introduction: Telemonitoring technologies enable medical teams to remotely manage outpatients with heart failure (HF) and reduce their risk of HF-related hospitalizations. However, noncompliance threatens the effectiveness of these approaches. This review aims to identify whether patients who are less likely or unable to comply with telemonitoring and their instructions for use are represented by interventional telemonitoring studies, and if their exclusion from studies is resulting in study findings not representative of clinical reality. Methods: A narrative literature review was conducted to identify interventional telemonitoring studies reporting compliance rates for HF patients. A search of PubMed and Medline databases identified eligible studies published between January 2000 and June 2021. Results: Twenty-five (n = 25) eligible studies with an interventional study design were identified. Reported compliance with telemonitoring ranged between 37% and 98.5%; however, 72% of studies reported good or medium compliance. A majority (76%) of studies had exclusion/inclusion criteria favoring the enrollment of patients who may be more likely to comply with telemonitoring and their instructions for use. Forty percent of studies had a sample with a mean or median age of <65 years. Participants were more likely to be male (majority in 92% of studies) and white (majority in 78% of studies that reported ethnicity). Conclusion: Compliance rates reported by current studies are unlikely to be generalizable to the wider HF population, particularly patients who are less likely or unable to comply with telemonitoring. Studies are therefore likely overestimating compliance rates. Future innovation should focus on designing \"low compliance\" solutions that require minimal engagement from users and future studies should aim to recruit a more generalizable cohort of patients. To achieve a more standardized metric of compliance, studies should report compliance (however defined) achieved by the 25th, 50th, and 75th percentile of all patients enrolled.","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"467-480"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39179775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and Visit Characteristics of Families Accessing Pediatric Urgent Care Telemedicine During the COVID-19 Pandemic.","authors":"Patricia Solo-Josephson,&nbsp;Joanne Murren-Boezem,&nbsp;Cynthia M Zettler-Greeley","doi":"10.1089/tmj.2021.0135","DOIUrl":"https://doi.org/10.1089/tmj.2021.0135","url":null,"abstract":"<p><p><b>Introduction:</b> Telemedicine expansion during the coronavirus pandemic improved health care access for some. However, studies show disparate uptake among marginalized communities, where minority patients experience higher infection rates. We examined changes in pediatric telemedicine utilization as related to social determinants of health and characteristics of families accessing care. <b>Materials and Methods:</b> This IRB-approved study is a retrospective, cross-sectional comparison of completed visits for parent-initiated, urgent care telemedicine services received by a pediatric health care system between January to May 2019 and January to May 2020. Patient and visit characteristics were evaluated by region (Florida or Delaware Valley) and year for age, race, gender, ethnicity, zip code, language, median household income, insurance type, and patient draw. <b>Results:</b> Outcomes varied by region. Pediatric patient visits jumped by 172% in 2020 from the year prior. In Florida, the proportion of Hispanic patients utilizing telemedicine increased, as did patients utilizing government-supported health insurance during the pandemic (<i>p</i>s < 0.05). Practically meaningful, although nonsignificant increases in patient language diversity were found across years in both regions (<i>p</i>s > 0.05). Rural patient utilization remained low (2-5%; <i>p</i>s > 0.05). <b>Discussion:</b> Changes in telemedicine use were observed among pediatric patients in vulnerable populations during the coronavirus disease 2019 (COVID-19) pandemic. Despite increased utilization among Hispanic and low-income families, access to virtual care remains a challenge among patients residing in rural locales. <b>Conclusion:</b> Researchers, health care providers, and policymakers should examine the implementation of varying mitigation strategies that support equal access and use of virtual health care among an increasingly diverse, post-COVID-19 pediatric patient population.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"558-565"},"PeriodicalIF":4.7,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}