Preoperative Hospitalist Telehealth Visits for Medically Complex Children During the COVID-19 Pandemic

Abstract

BACKGROUND During the coronavirus disease 2019 pandemic, telehealth has emerged as an alternative to in-person visits. Our children’s hospital’s preoperative program includes a pediatric hospitalist evaluation of medically complex patients undergoing elective orthopedic surgery. Starting in March 2020, patients were offered either in-person or telehealth preoperative visits. Few data exist regarding preoperative telehealth for medically complex children. We sought to assess this program’s practicality and compare clinical characteristics, demographic data, and visit outcome data of patients seen via telehealth versus those seen in person. METHODS We retrospectively collected demographic or clinical data, visit characteristics, and visit outcome data of medically complex children scheduled for orthopedic surgery seen April-October 2020. We reviewed the data to compare characteristics of patients seen in person to those seen via telehealth. RESULTS We reviewed 68 visits: 34 (50%) telehealth and 34 (50%) in-person. There was no statistically significant difference in telehealth use by primary language, insurance type, underlying medical condition, gross motor function classification system score, or technology dependence. There was no significant difference between the median number of hospitalist recommendations (4 telehealth vs 3 in-person, P = .553) or progression to surgery (32 vs 32, odds ratio 1.000, confidence interval 0.133–7.540) on the basis of visit type. CONCLUSIONS A preoperative telehealth program is practical for medically complex children. We found no significant difference in telehealth use between technology-dependent patients and those who are not. Further study of preoperative telehealth visits will hopefully be broader in scope.