Telehealth May Improve Outcomes for Children with Chronic Conditions

Using telehealth to deliver comprehensive care for children with chronic conditions is likely to reduce hospital and emergency department visits, improve patient outcomes, and decrease healthcare costs, according to researchers at the University of Texas Health Science Center at Houston (UTH). 

Children with medically complex conditions account for .04 percent of children but make up around 40 percent of pediatric deaths and 53 percent of pediatric hospital charges. 

Researchers used telehealth to provide comprehensive care services to medically complex children in an attempt to boost health outcomes, care delivery and convenience for families. 

Between August 22, 2018 and March 23, 2020, UTH researchers randomly assigned 422 children who received treatment at UTH’s High-Risk Children’s Clinic to either telehealth treatment or in-person treatment. 

The telehealth group received care via Zoom for Healthcare. Families received assistance with downloading the app, creating an account and learning how to use the app for audio-visual conferencing.

Families were hesitant to use telehealth at the beginning, but utilization grew as the study progressed, researchers noted. There were 10 telehealth visits during the first month of the trial and 55 during the last month, averaging 16 telehealth visits per month for the duration of the study.

For both in-person and telehealth visits, researchers looked at how many days patients received care in a hospital or ED and the health outcomes, hospital admissions and readmissions, pediatric intensive care unit (PICU) admissions, and serious illnesses in the patients. 

The study found that telehealth visits were likely to reduce the number of hospital visits for medically complex children. The probability for an overall reduction was 99 percent. The probability for a reduction in serious illnesses was also high, at 95 percent. Total hospital and PICU admissions were likely to decrease as well, with 90 and 97 percent reduction probability, respectively.

Telehealth visits resulted in reduced health system costs due to the low utilization of hospital and ED services, according to the study. The use of telehealth cost the health system $33,718, whereas in-person care cost $41,281. The results identified a 91 percent probability of reduced health system costs.

Pediatric telehealth use may provide a more convenient and safer option for children with chronic conditions to receive care. Children can access care quicker without risking exposure in a clinic or hospital, which is especially beneficial during the COVID-19 pandemic. 

Telehealth also has the potential to foster better relationships between families and their primary care providers and provides the benefit of children receiving care from a provider that is familiar instead of an emergency department physician.