453 Technological barriers to video consultations in paediatrics

Abstract

<h3>Aims</h3> To report the technological barriers (access to devices, and connectivity) with video consultations in paediatrics reported in the medical literature. <h3>Methods</h3> A systematic review was undertaken with searches of PudMed, Embase, and CINAHL databases in the areas of Paediatric Asthma, Diabetes, Epilepsy, and Nephrology. Included studies’ data were interrogated for information regarding issues with connectivity, or access to devices that enabled video consultations. <h3>Results</h3> Of the 3,004 identified articles following exclusions and review, seven reported challenges of implementation of video consultations with families related to connectivity or access to technology to facilitate video consultation ranging from 7% to 89%. By speciality, the percentage of reported issues with connection or lack of technology accessibility was: Epilepsy 25% (France, n=105) and 9% (Italy, n=3,321); Nephrology 89% (UK, n=18); Asthma 9% (India, n=112) and 27% (USA, n=60); and Diabetes 14% (USA, n=57) and 20% (Spain, n=15). Combining these results, gives a total barrier to video consultation due to challenges with access or connectivity of 10%. Studies did not report numbers and reasons for non-recruitment, that might have included such technical barriers. <h3>Conclusion</h3> The use of video consultations offer the potential for savings in time, money, and carbon emissions for families and healthcare providers. This review highlights an important barrier for their use, and, importantly, equitable access. The connectivity and access to video consultations barrier prevalence of 10% may be an underestimation due to many studies not reporting this barrier but reporting acceptability and feasibility of a self-selected group, or in studies in which inclusion criteria necessitated internet access. Although video call facilities are becoming increasingly available and the UK having some of the greatest internet penetration of any country, in the UK 4% of households still do not have access to the internet. Moreover, minimum connection speeds are needed for video consultations. 3.1% to 4.7% of broadband lines in the UK do not have capacity to host 1.5 Mbits/sec connection needed for standard video calls, and 7.8 to 9% that of 3 Mbits/sec needed for high quality high definition video calls. These factors may contribute to the success of wide-spread, and equitable access to video consultations.