A Year of Inpatient Telehealth: Lessons From the COVID-19 Pandemic

Author:

Hron Jonathan D.12,Payvandi Lily34,Parsons Chase R.12,Bourgeois Fabienne C.12

Affiliation:

1. aDivision of General Pediatrics, Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts

2. bDepartment of Pediatrics, Harvard Medical School, Boston, Massachusetts

3. cDepartment of Family Medicine, Boston Medical Center, Boston, Massachusetts

4. dDepartment of Family Medicine, Boston University School of Medicine, Boston, Massachusetts

Abstract

BACKGROUND Relaxation of telehealth regulation enforcement during the coronavirus disease 2019 pandemic opened the door to massive expansion. Here we describe inpatient telehealth usage across a pediatric academic hospital during the first year of the pandemic. METHODS We created hospital bed-specific inpatient telehealth accounts and monitored their use over a 1 year period using data from our video conferencing vendor. We matched data with our enterprise data warehouse based on session date and time to identify patients who participated in telehealth. We performed secondary analysis of all video conferences to identify additional multidisciplinary team and family meetings that did not leverage the bed-specific telehealth accounts. RESULTS We hosted 6931 inpatient telehealth sessions associated with 1648 unique patients. Hospitalized patients participating in telehealth sessions were older and had markedly longer length of stay compared with those who did not use telehealth (median age 12 vs 8 years, P < .001; median length of stay 9.03 vs 2.03 days, P < .001). There were 2006 charges for telehealth sessions, half of which were from psychiatry providers. Secondary analysis revealed an additional 1132 sessions used for interdisciplinary team or family meetings. CONCLUSIONS Clinicians used inpatient telehealth to support care of hospitalized pediatric patients during the coronavirus disease pandemic, particularly for mental health care and family meetings. These findings suggest ongoing opportunities for inpatient telehealth systems beyond the pandemic.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health

Reference35 articles.

1. US Department of Health and Human Services. Notification of enforcement discretion for telehealth. Available at: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html. Accessed March 26, 2020

2. Office of the Governor, Commonwealth of Massachusetts. Order expanding access to telehealth services and to protect health care providers. Available at: https://www.mass.gov/doc/march-15-2020-telehealth-order/download. Accessed April 1, 2020

3. Samson L, Tarazi W, Turrini G, Sheingold S. Medicare beneficiaries’ use of telehealth in 2020: trends by beneficiary characteristics and location. Available at: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet. Accessed December 9, 2021

4. Rapid implementation of an inpatient telehealth program during the COVID-19 pandemic;Hron;Appl Clin Inform,2020

5. Inpatient telehealth experience of patients with limited English proficiency: cross-sectional survey and semistructured interview study;Payvandi;JMIR Form Res,2022

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