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      Pediatric Subspecialty Adoption of Telemedicine Amidst the COVID-19 Pandemic: An Early Descriptive Analysis

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          Abstract

          Telemedicine has rapidly expanded in many aspects of pediatric care as a result of the COVID-19 pandemic. However, little is known about what factors may make pediatric subspeciality care more apt to long-term adoption of telemedicine. To better delineate the potential patient, provider, and subspecialty factors which may influence subspecialty adoption of telemedicine, we reviewed our institutional experience. The top 36 pediatric subspecialties at Stanford Children's Health were classified into high telemedicine adopters, low telemedicine adopters, and telemedicine reverters. Distance from the patient's home, primary language, insurance type, institutional factors such as wait times, and subspecialty-specific clinical differences correlated with differing patterns of telemedicine adoption. With greater awareness of these factors, institutions and providers can better guide patients in determining which care may be best suited for telemedicine and develop sustainable long-term telemedicine programming.

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          Most cited references23

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          Covid-19 and Health Care’s Digital Revolution

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            Patient Characteristics Associated With Telemedicine Access for Primary and Specialty Ambulatory Care During the COVID-19 Pandemic

            Key Points Question What sociodemographic factors are associated with higher use of telemedicine and the use of video (vs telephone) for telemedicine visits for ambulatory care during the coronavirus disease 2019 (COVID-19) pandemic? Findings In this cohort study of 148 402 patients scheduled for primary care and medical specialty ambulatory telemedicine visits at a large academic health system during the early phase of the COVID-19 pandemic, older age, Asian race, non-English language as the patient’s preferred language, and Medicaid were independently associated with fewer completed telemedicine visits. Older age, female sex, Black race, Latinx ethnicity, and lower household income were associated with lower use of video for telemedicine care. Meaning This study identified racial/ethnic, sex, age, language, and socioeconomic differences in accessing telemedicine for primary care and specialty ambulatory care; if not addressed, these differences may compound existing inequities in care among vulnerable populations.
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              Addressing Equity in Telemedicine for Chronic Disease Management During the Covid-19 Pandemic

              The coronavirus crisis exposes disparities in access to care for vulnerable populations, particularly with respect to telemedicine. There is, however, an opportunity, as payers and providers are temporarily embracing expanded use of video visits, to establish practices that will mitigate inequities now and prevent future disruption of chronic disease management.
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                Author and article information

                Contributors
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                13 April 2021
                2021
                13 April 2021
                : 9
                : 648631
                Affiliations
                [1] 1Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Lucile Packard Children's Hospital—Stanford Children's Health, Stanford University School of Medicine , Stanford, CA, United States
                [2] 2Information Services Department, Stanford Children's Health , Stanford, CA, United States
                [3] 3Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Lucile Packard Children's Hospital—Stanford Children's Health, Stanford University School of Medicine , Stanford, CA, United States
                [4] 4Division of Pediatric Rheumatology, Department of Pediatrics, Lucile Packard Children's Hospital—Stanford Children's Health, Stanford University School of Medicine , Stanford, CA, United States
                [5] 5Division of General Pediatrics, Department of Pediatrics, Lucile Packard Children's Hospital—Stanford Children's Health, Stanford University School of Medicine , Stanford, CA, United States
                [6] 6Division of Pediatric Otolaryngology, Department of Otolaryngology—Head and Neck Surgery, Lucile Packard Children's Hospital—Stanford Children's Health, Stanford University School of Medicine , Stanford, CA, United States
                Author notes

                Edited by: Priya Sara Verghese, Ann & Robert H. Lurie Children's Hospital of Chicago, United States

                Reviewed by: Michelle Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, United States; Lyndsay Harshman, The University of Iowa, United States

                *Correspondence: Kara D. Meister meister4@ 123456stanford.edu

                This article was submitted to Pediatric Nephrology, a section of the journal Frontiers in Pediatrics

                Article
                10.3389/fped.2021.648631
                8076568
                28a71298-10e7-45cb-b17b-c48fe290d920
                Copyright © 2021 Xie, Prahalad, Lee, Stevens and Meister.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 01 January 2021
                : 16 March 2021
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 25, Pages: 8, Words: 5613
                Categories
                Pediatrics
                Original Research

                telemedicine,telehealth,pediatric,subspecialty,access,covid-19
                telemedicine, telehealth, pediatric, subspecialty, access, covid-19

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