Rapid development of telehealth capabilities within pediatric patient portal infrastructure for COVID-19 care: barriers, solutions, results

Abstract The COVID-19 national emergency has led to surging care demand and the need for unprecedented telehealth expansion. Rapid telehealth expansion can be especially complex for pediatric patients. From the experience of a large academic medical center, this report describes a pathway for effici...

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Bibliographic Details
Published in:Journal of the American Medical Informatics Association : JAMIA 2020-07, Vol.27 (7), p.1116-1120
Main Authors: Patel, Pious D, Cobb, Jared, Wright, Deidre, Turer, Robert W, Jordan, Tiffany, Humphrey, Amber, Kepner, Adrienne L, Smith, Gaye, Rosenbloom, S Trent
Format: Article
Language:English
Subjects:
Adolescent
Betacoronavirus
Brief Communications
Child
Child, Preschool
Confidentiality
Consumer Health Informatics
Coronavirus Infections - therapy
COVID-19
Editor's Choice
Female
Humans
Infant
Male
Pandemics
Parents
Patient Portals
Pneumonia, Viral - therapy
SARS-CoV-2
Telemedicine - statistics & numerical data
Telemedicine - trends
Tennessee
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Summary:Abstract The COVID-19 national emergency has led to surging care demand and the need for unprecedented telehealth expansion. Rapid telehealth expansion can be especially complex for pediatric patients. From the experience of a large academic medical center, this report describes a pathway for efficiently increasing capacity of remote pediatric enrollment for telehealth while fulfilling privacy, security, and convenience concerns. The design and implementation of the process took 2 days. Five process requirements were identified: efficient enrollment, remote ability to establish parentage, minimal additional work for application processing, compliance with guidelines for adolescent autonomy, and compliance with institutional privacy and security policies. Weekly enrollment subsequently increased 10-fold for children (age 0–12 years) and 1.2-fold for adolescents (age 13–17 years). Weekly telehealth visits increased 200-fold for children and 90-fold for adolescents. The obstacles and solutions presented in this report can provide guidance to health systems for similar challenges during the COVID-19 response and future disasters.
ISSN:1527-974X
1067-5027
1527-974X
DOI:10.1093/jamia/ocaa065