Abstract
Objective
In March 2020, regulatory and payment changes allowed “brick and mortar” pediatric
practices to offer practice-based telemedicine for the first time, joining direct-to-consumer
(DTC) telemedicine vendors in the ability to offer visits for common acute pediatric
concerns via telemedicine. We sought to characterize the relative contribution of
practice-based telemedicine versus commercial DTC telemedicine models in provision
of children's telemedicine from 2018 through 2021.
Methods
Using January 2018 to September 2021 data from Optum's de-identified Clinformatics®
Data Mart Database, we identified telemedicine visits by children ≤17, excluding preventive
visits and visits to specialists, emergency departments, and urgent care. Among included
visits, we defined “telemedicine-only” providers as those with ≥80% of visits via
telemedicine and practice-based telemedicine providers as those with ≤50% of visits
via telemedicine. We then described the telemedicine visit volume and diagnoses for
these categories overall and per 1000 children per month.
Results
From January 2018 to February 2020, telemedicine-only providers accounted for 57,815
telemedicine visits (90.8%), while practice-based telemedicine accounted for 4192
telemedicine visits (6.6%). From March 2020 to September 2021, telemedicine-only providers
accounted for 38,282 telemedicine visits (6.1%), while practice-based telemedicine
accounted for 555,125 telemedicine visits (88.2%). Per month, telemedicine visits
to practice-based telemedicine providers increased from pre-pandemic to pandemic periods
(0.1 vs 12.9 visits per 1000 children/month), while telemedicine visits to telemedicine-only
providers occurred at a similar rate from pre-pandemic to pandemic periods (0.92 vs
0.96 visits per 1000 children/month).
Conclusions
We observed a large increase in telemedicine visits during the pandemic, with the
growth in visits exclusively occurring among visits to practice-based telemedicine
providers as opposed to telemedicine-only providers.
Keywords
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Article Info
Publication History
Published online: May 16, 2022
Accepted:
May 11,
2022
Received:
January 14,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors have no conflicts of interest relevant to this article to disclose.
Identification
Copyright
Copyright © 2022 by Academic Pediatric Association
