O3294: Utility of Video Telehealth Implementation in a Pediatric Transport System: A Provider Perspective

Purpose/Objectives: The use of telemedicine in transport of pediatric patients between healthcare facilities is a developing practice in healthcare but remains largely unstudied. We implemented a telehealth program for the pediatric transport team to facilitate patient care. This abstract describes the experience and utility from the providers perspective during a video telehealth implementation.

Design/Methods: Telehealth was implemented for pediatric transport team for all pediatric intensive care and emergency department transfers to a single center tertiary care children’s hospital. Data was collected for two 6-month periods pre- and post-implementation of a video telehealth transport protocol. Initially, transport teams placed telephone calls to the Pediatric Intensive Care Unit or the Emergency Department after initial patient assessment. After intervention, the accepting providers performed a telehealth consultation using Doximity via a tablet prior to transport, switching to telephone consult only if unable to make connection with video. Patient demographics, items discussed on the call, call times, technical difficulties and perceived benefit using a 7-point Likert scale were assessed via a RedCap Survey done after the call. Chi squared, Fisher’s exact and Wilcoxon Signed Rank test were used to compare pre- and post-implementation data.

Results: A total of 463 transports records were eligible for analysis that were equally split between pre- and post-telehealth implementation. Post-implementation, a video call was completed 73.8% of the time. Compliance with survey completion by the transport team was 62.9% pre and 64.7% post. Survey compliance by the accepting providers was 71.9% pre and 50.4% post. There was no significant difference in the pre- and post-implementation Likert scale for perceived benefit for either the transport team or the provider team. Patient exam was less likely to be discussed post-telehealth implementation, with it being discussed 86% of calls pre-implementation and 75% of the time post-implementation (p=0.01). Both groups reported significantly increased technical difficulties, mostly due to poor video quality (p≤0.01). Otherwise, there was no significant change in patient management, call times, or patient disposition (ED or PICU) as a result of these video calls.

Conclusion/Discussion: Both inpatient providers and transport teams did not perceive a significant change in the benefit of pre-hospital communication based on type of communication method, even on calls without technical issues. However, there was a trend toward lower calls times on telehealth call which could be beneficial for these specialized transport teams that are in high demand. Future directions include involving caregivers on the video calls as early video communication with their primary providers could be beneficial.