Abstract 10772: Telemedicine in a Pediatric Lipid Clinic: Feasibility, Acceptability, and Health Care Disparities

Abstract

Introduction: During the COVID-19 pandemic, telemedicine became an essential way to provide patient care. We assessed the feasibility, acceptability, and initial impact on health care disparities of using telemedicine in a large pediatric lipid clinic. Methods: Data were collected from a telemedicine (TM) cohort between 4/1/20-3/31/21 and compared to an in-person (IP) cohort between 1/1/19-3/13/20. Families participated in telemedicine visits through an online patient portal. Interpreter services were available. Family surveys were sent after each telemedicine visit; providers were surveyed monthly. We evaluated family and provider satisfaction, cancellation rates, travel-related time and costs, and visit duration (check-in to check-out). Data were analyzed using standard descriptive summaries and student’s t-test. Results: Five providers completed 784 lipid telemedicine visits, accounting for 79% of total visit volume between 4/1/20-3/31/21. Average age was 14 years (+/- 3.8 yrs) and 366 (46.7%) were male. Interpreters were used in 11 (1.4%) visits. Payor mix (Medicaid vs. commercial) was comparable between TM (19.9%) and IP cohorts (22.4%). Of 98 completed telemedicine family surveys, 18 (18.4%) noted technical difficulties; however, nearly all families were interested in future telemedicine visits. Sixteen monthly provider surveys were completed: 31% reported technical difficulties and rated telemedicine 9.1/10. The 48-hour cancellation rate decreased from 11% to 7% (IP and TM cohort, respectively, P < 0.018), with a decrease from 25% to 5% for Non-Hispanic Black patients ( P < .001). No show rates were consistent between cohorts at 2%. Total driving distance saved was 20,800 miles with an estimated travel-related savings of $11,440. Average visit time for IP cohort was 87.5 minutes compared to 39.5 minutes for the TM cohort. Conclusion: We found that using telemedicine in a pediatric lipid clinic is feasible, time efficient, and associated with travel-related time and cost savings. There was a significant decrease in 48-hour cancellation rates overall, most notably for Non-Hispanic Black patients. Future studies utilizing telemedicine in our clinic will evaluate the effect on long term cardiovascular risk and health care delivery.