286 - Family Experience of Telemedicine Care: Findings from National Focus Groups

Poster Number: 286
Publication Number: 286.346

Sara W. Buscher, Boston Children's Hospital, Boston, MA, United States; J L. Hargraves, Center for Survey Research @ UMass Boston, Boston, MA, United States; Carol Cosenza, University of Massachusetts Boston, Boston, MA, United States; Alyna T. Chien, Division of General Pediatrics, Boston Children's Hospital, Brookline, MA, United States; Asher K. Baden, Boston Children's Hospital, Boston, MA, United States; Mark Schuster, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States; Sara Toomey, Boston Children's Hospital, Boston, MA, United States

Background: The COVID pandemic accelerated the growth of telemedicine. In pediatrics, video visits involve both patients and families. Little is known about how parents experience video visits.

Objective: To examine family experience of pediatric outpatient video visits.

Design/Methods: We conducted focus groups with 47 parents of pediatric patients from across the US who received telemedicine care in the prior 3 months; 8 were in English (with 37 parents) and 2 (10 parents) were in Spanish. We conducted thematic analysis to identify salient themes relating to family experience.

Results: 70% were female, 30% male; 13% Asian, 21% Black, 44% Hispanic and 32% White; 49% publicly insured; 51% had ≥ 4-year college education; 30% Northeast, 40% Midwest, 11% West, 19% South. Type of video visits varied: primary care/well child, urgent care, specialty care, and mental/behavioral health. Three main themes emerged (Table 1). 1) Access to Care/Convenience of Telemedicine: Many noted that it is easy to get timely access to care via telemedicine. Convenience was mentioned by nearly all, allowing for families to avoid hassles of in-person visits. 2) Communication with Clinician: Experiences varied. Parents who had in-person visits with the provider before the telemedicine visit had fewer concerns with video communication. Some noted that telemedicine did not offer the same level of connection with the clinician. Spanish-speaking parents explained that, via video, they often did not have access to their child’s regular bilingual provider and had more issues than with in-person interpretation. 3) Overall Value of the Visit: For certain visits, including follow-up and conversation-based visits, parents found telemedicine to be valuable. Several said how telemedicine required them to do more during the visit, which could be positive or negative. As one described, “I felt like my son’s personal nurse.” Some felt that the visit was not thorough in evaluating their child and reported needing to go in person after the video visit for the clinician to make a diagnosis.Conclusion(s): The positive aspects of telemedicine included offering families greater convenience and accessibility; communication was enhanced if they already had established relationships with providers and interpreters. However, it often came with trade-offs, including lack of perceived thoroughness of the visit and the need for parents to sometimes support clinicians during exams. Successful delivery of telemedicine care may require that providers and office staff effectively triage patients into video or in-person care, balancing clinical needs and family preferences.
Table 1. Main themes and illustrative quotes identified in focus groups with parents of pediatric patients who had a recent telemedicine visit