Pediatric Telemedicine Poised for Growth Spurt

Data from Nemours Children's Health System suggests that the percentage parents who are willing and eager to use telemedicine services for their children has grown exponentially in the past three years.

The use of pediatric telemedicine may soon be at a tipping point.

A survey this by Nemours Children's Health System shows that while only 15% of the 500 parents who responded to an online query have accessed pediatric telemedicine, 64% plan to use it within the next year for common childhood conditions such as fever and respiratory ailments and for well-child visits.

Overall, the percentage of parents who use telemedicine remains small. When compared with a 2014 survey by Nemours, however, the use of online doctors' visits has grown by 125%, and parents' awareness of telemedicine services has increased 88%.

"That's a very good sign that people are becoming more and more aware of telemedicine being an option," says Carey Officer, administrator of telehealth at Wilmington, DE-based Nemours.

Chasing the ROI of Telemedicine

"They're changing that mental model in their head of how they can access care. There's been tremendous growth year over year in the adult population and we've seen tremendous growth when we opened our digital door back in 2015. Every month the visits continue to grow."

Socio-demographic factors are converging in a way that Officer says will accelerate the acceptance of telemedicine. Namely, it's cheaper, faster and more convenient than a trip to a physician's office or an urgent care center.

Nemours charges $49 for a basic 10-minute telemedicine consultation. In addition, technology has improved and simplified the accessibility and navigability of healthcare portals for tech-savvy millennials juggling parenthood and careers.

"We are starting to see the tipping point," Officer says. "Things have been accelerating in the past year or two and I think consumers are going to demand it. These parents are millennials and they like to use digital healthcare. They understand it. They know it. They prefer the convenience. So, how do we meet them where they are?"

Parents are most willing to use telehealth services for cold and flu (58%), pinkeye (51%), rashes (48%), and well-child visits (41%), which accounted for an estimated 171 million in-office visits in 2012 for children under 18, according to the Centers for Disease Control and Prevention.

Parents are less accepting of telemedicine for treating chronic conditions. Those surveyed said they likely would never consider using telehealth services for diabetes (53%), asthma (43%), and ADHD (36%), even though previous research has shown that chronic care can be effectively treated through telemedicine.

"The reason why this hasn't take off more rapidly for chronic conditions is that the 24/7 urgent care model has prevailed and is dominant in the marketplace right now," Officer says. "You have payers and employers who are advertising this to their patients and employees and people haven't been educated, nor has it been deployed to the extent of the 24/7 on-demand urgent care model."

"We are pursuing telemedicine for asthma and diabetes and other critical areas where we think we can intervene to assist in the reduction of readmissions and improve outcomes by meeting patients where they are and alleviating emergency room visits for patients who come in frequently," she says.

Positive Patient Experience

Among parents who have tried an online doctor visit for their child, nearly all of them (97.5%) rated the experience as equal to or better than an in-office visit. Most parents who have already had an online doctor visit for their child cite convenience (81%) as a prime reason for choosing online rather than in-office doctor visits.

"The comments that are coming back from parents who used it for the first time are telling us 'Wow! I had no idea this could be so convenient,'" Officer says. "You can have a doctor on line in five minutes and they can help you solve your problem from the comfort of your own home."

The survey also found that:

• Dads surveyed were more likely to have already used telemedicine services for themselves or their children (34%), compared to moms (22%).
   
• A majority of those who have already had an online doctor visit for their child also looked to telemedicine for more immediate care than waiting for an in-office visit (53%) or for an after-hours medical opinion (52%).
   
• Half of the parents said they were comfortable with trying new remote sensing devices on smartphone for sending vitals or other clinical measures to a doctor, and 29% of that group already had had an online doctor visit for their child. This suggests a pattern of "early adopters" for new technologies in pursuing children's healthcare.

Many parents report that work schedules and time pressures create problems for securing in-office appointments. The American Academy of Pediatrics reports that parents spend an average of 30 hours on well-child visits during their child's first five years.

According to Nemours' survey results, parents who have used telemedicine cited convenience, after-hours accessibility, and immediacy as the top three reasons for doing so. Three-out-of-four parents rated the experience as superior to an in-office doctor visit.

Nemours has implemented its CareConnect 24/7 telemedicine throughout its health system with direct-to-consumer care for acute, chronic, and post-surgical appointments, as well as through its partner hospitals, schools, and even cruise ships.

Families can access the Nemours pediatricians through a smartphone, tablet, or computer. When necessary, the physician may order a prescription, using geo-location service on the smartphone or tablet, and send it to the nearest pharmacy.  

The biggest speed bumps for the expanded use of telemedicine are beyond the control of providers, Officer says.

"What is hampering the growth at this point is the regulatory and reimbursement environment, from licensing to payer reimbursement," she says.