The Before Picture: Assessing the Value of Telemedicine from the Perspective of the Caregiver Presenting to a Pediatric Surgery Clinic Prior to COVID-19

Background: Within pediatrics, the use of telemedicine has grown considerably within the past decade, mostnotably within primary care and behavioral health However, within pediatric surgery the increase in use hasbeen modest In response to COVID-19, many healthcare institutions implemented strategies to curb thespread of the virus, including restricting non-emergent clinic appointments and quickly rolling outtelemedicine options for patients The utility of telemedicine options beyond the COVID-19 restrictive periodhas not been studied The purpose of this study is to assess the state of interest in telemedicine for caregiverspresenting to a pediatric surgery clinic prior to COVID-19 and to evaluate the potential benets of continuingtelemedicine use within pediatric surgery based on the caregiver perspective Methods: Following IRBapproval, caregivers for all patients that presented to a general pediatric surgery clinic from January 1, 2020 toMarch 1, 2020, were considered for enrollment Subjects were asked to complete a voluntary and anonymous survey Survey responses were recorded directly into REDCap by participants Categorical variables wereevaluated using frequencies and reported as percentages Results: In total, 58 caregivers completed a survey The majority (51%) of respondents were between 31-40 years old, with 71% identifying as Caucasian and 22%as African American A fourth (25%) of respondents traveled at least 100 miles, with more than one-third (36%)spending a minimum of 2 hours in travel time To get to and from the clinic appointment, 69% reportedspending at least $10 in fuel, with 13% spending more than $50 Three-quarters (75%) of participants reportedworking outside of the home, and the majority (53%) had to miss work for the appointment, resulting inmissed wages for 41% of respondents All caregivers had a cellphone and 93% had access to a computer ortablet, with 87% reporting daily internet use and 71% reporting use of video chat at least once per week Only26% of respondents were familiar with telemedicine prior to taking the survey However, following a briefdescription, 66% responded that they would be interested in remote appointments, with 74% citing cost as areason and 69% stating that time spent traveling was an important factor For 91% of respondents the mostimportant factor related to the visit was getting the correct diagnosis Conclusion: The COVID-19 restrictiveperiod has led to increased use of telemedicine within pediatric surgery Prior to COVID-19 most caregiverspresenting to a pediatric surgery clinic were unfamiliar with telemedicine options, however, the majority wereinterested in the benets afforded by remote evaluation Future studies are needed to determine how best tocontinue the use of telemedicine for the treatment of pediatric surgery patients beyond the restrictive period