491 - Telemedicine in Adolescent and Young Adult Medicine: Patient and Parent Perspectives

Poster Number: 491
Publication Number: 491.100

Angela Barney, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Sabrina I. Mendez-Contreras, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Sara M. Buckelew, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States; Charles E. Irwin, University of California San Francisco, Berkeley, CA, United States; Marissa Raymond-Flesch, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States

Background: Nationwide, telemedicine use expanded rapidly in 2020 to limit transmission of Covid-19. Given the complex physical and mental health needs of Adolescents and Young Adults (AYAs), this population may benefit from increased access to primary and sub-specialty care through telemedicine, particularly as surges of Covid-19 continue to disrupt access to care. Care of AYAs often requires both family engagement and patient confidentiality, creating unique complexities in delivering telemedicine to AYAs. To optimize quality and access of care for this group, it is essential to understand patient and family experiences and preferences related to telemedicine.

Objective: This study's objective is to describe AYA patient and parent perceptions of telemedicine in an Adolescent and Young Adult Medicine clinic, including access barriers and confidentiality of telemedicine.

Design/Methods: 20 patients ages 13-25 (11 minors, 9 young adults) and 10 parents of patients of the UCSF Adolescent and Young Adult Medicine Clinic participated in in-depth interviews including questions about their experiences accessing telemedicine, barriers to using telemedicine, and impact of telemedicine on patient/provider relationship and confidentiality. Interviews were conducted in English or Spanish via secure video chat or telephone, recorded, and transcribed. Spanish interviews were professionally translated to English for analysis. Two authors completed iterative rounds of memos and thematic identification, with themes reviewed by the remaining authors.

Results: Many patients preferred the human connection of clinic visits over telemedicine. Participants reported better communication in clinic compared to telemedicine. Generally, participants thought confidentiality and privacy were adequate with telemedicine, although a few expressed concerns that the home environment lacks privacy for patients during “alone time” with a provider. Participants reported adequate device access for telemedicine, but some noted that visits may be interrupted by slow or unreliable internet. Many noted the convenience of telemedicine visits, especially those with geographic or transportation barriers accessing specialized care in person.Conclusion(s): This study suggests that many AYAs, despite being digital natives, may prefer face-to-face interactions with medical providers. Parents and AYAs felt less engaged in telemedicine visits than in clinic visits. Since telemedicine can expand access to health services, further research is needed to improve patient/provider communication and ensure patients are assured confidentiality in telemedicine visits.
Angela Barney CVAngela Barney - CV.pdf