for children:
Key considerations
for medical providers

Author: Satta Sarmah Hightower

In the last year, almost every part of our lives has gone virtual. While adults adjusted to remote work, children (and their teachers) faced the challenges of distance learning. When it came to healthcare, in March 2020 alone telehealth visits in the U.S. increased 154% from the year before. Pediatric telehealth requires several unique considerations from a technology, care and equity perspective and there are efforts underway to make delivering telemedicine for children more equitable.

The importance of pediatric telemedicine for healthcare providers that treat children

Telemedicine has been used by health providers that treat children to manage children's potential exposure during the pandemic and to provide continuity of care. It allows healthcare providers practicing pediatric telemedicine for children to serve high-risk children either by video or phone via a secure remote platform or app. These services are incredibly beneficial for younger patients who may be in high-risk categories, according to a report published in Frontiers in Pediatrics, including pediatric rheumatology and neurosurgery patients, and who may just need to visit their doctor for routine care or a check-up. With the help of remote monitoring tools—such as wearable devices connected to apps—healthcare providers can evaluate these patients without the risks associated with an in-person visit.

As the American Academy of Pediatrics (AAP) notes, "Telehealth visits are part of a combined matrix of care options available to provide the right care in the right place at the right time." This is especially true with mental health services. Children have dealt with increased social-emotional challenges this past year, as they were more isolated and lacked the social development they'd traditionally get from being surrounded by their peers at school. According to the APP's "Interim Guidance on Supporting the Emotional and Behavioral Health Needs of Children, Adolescents and Families During the COVID-19 Pandemic," children who are struggling, telepsychiatry or telehealth mental health services can be valuable because they allow children to have the same conversation they'd have with a psychiatrist or mental health provider virtually. Plus, families benefit from the convenience, lack of travel costs, and not having to take a lot of time off work or school to access the care their child needs.

Pediatric telemedicine challenges

Even with all the benefits telemedicine for children provides, there are still several potential challenges. For one, most experts agree that in-person care is still better than a virtual visit: The AAP even has said that a pediatrician's office is the best place for children to receive care. However, the AAP also supports making care as accessible as possible to all children.

Pediatric telemedicine does expand care, but the technological requirements can pose a barrier to accessible care in some communities. Many rural areas and some urban areas lack broadband infrastructure or reliable internet connections, which makes it difficult to connect to the remote platforms or apps required for telehealth visits.

Similar to the challenges some children have faced with distance learning, some families also may not have the means to purchase high-speed internet or smartphone devices that connect to the internet. All of these things come at a cost, whether it's paying for a monthly data plan for a phone, standard internet or 5G service in the communities where this advanced connectivity is available. But even when families and providers have standard internet service, they may encounter performance issues, such as high latency that slows or stalls the connection, especially if the network a provider uses doesn't meet the bandwidth requirements for telehealth or if too many people in a hospital or healthcare center are trying to access the network at one time.

Another issue with telehealth is that these services may not be suitable for every condition or every patient. The AAP says initial newborn visits, comprehensive physical exams, diagnostic and in-office testing, and hearing, vision, and oral health screenings should still be done in a pediatrician's office. Some healthcare services, including immunizations, can't be done virtually, either, highlighting the inherent limitations of this approach to care.

It's also difficult to replicate the intimacy of the doctor-patient relationship in a remote setting. Along with experience, training and patient engagement, trust is crucial to providing quality care. In-person visits may help to forge and strengthen this trust more so than virtual visits because patients and providers interact face-to-face rather than within the four walls of a screen, which can feel more impersonal.

Telemedicine for Children: Overcoming pediatric telehealth challenges

To ensure children get the care they need, healthcare providers can take several steps to improve telemedicine for children.

First, providers should strengthen their network connectivity. If 5G service is available in a hospital or health system's local area, these institutions should consider upgrading to the highest service tier available from their provider.

Increasing network performance and reliability are also critical. A private IP network and wireless private network solution can help reduce latency, increase service reliability and—by extension—care continuity. With these solutions, healthcare organizations can establish a secure digital foundation they can use to strengthen enterprise security, secure remote connections, and connect modern tools and applications, whether it's for pediatric telehealth or other uses. This can reduce the risk that poor connections don't undermine the patient experience during a virtual visit.

However, addressing digital equity issues will be an ongoing challenge for most healthcare organizations. Some patients may not have the means to purchase smartphones or to upgrade their computers to connect to telehealth services. There are hundreds, if not thousands, of communities across the country that are considered "digital deserts," and it will take larger, more systemic solutions—including making internet and broadband access more affordable and more prevalent—to repair this digital divide.

Healthcare providers also will need to educate patients about how to access and effectively use these services. Short instructional videos and user-friendly instructional guides can help patients get more comfortable with these technologies, along with making sure staff members are adequately trained.

Pediatric telehealth shows just how much healthcare has transformed. Telemedicine for children and adults alike is expanding care access. It won't ever completely replace in-person care, but it's an invaluable complement to it and can help clinicians provide the right care to the right patient at the right time.

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