Global Trends in Telehealth Among Clinicians in Developmental-Behavioral Pediatric Practice: A COVID-19 Snapshot.

Abstract

This study aims to describe the extent of telehealth use by global developmental-behavioral pediatrics (DBP) clinicians and barriers (if any) in adopting telehealth during the coronavirus disease 2019 (COVID-19) pandemic. A survey was disseminated to DBP clinicians through contact with international professional organizations to determine the use of telehealth in DBP care, before and since the beginning of the COVID-19 pandemic. Descriptive statistics and χ2 tests were used for analysis. A total of 271 respondents from 38 countries completed the survey. The number of respondents offering telehealth increased from 36% to 88% after the pandemic, with the greatest shift to telehealth among high-income countries (HICs). Among respondents using telehealth, 75.1% were conducting interactive video visits, with HICs using more telehealth modalities embedded in electronic health records. Most patients (98.7%) were at home for the telehealth encounter. Almost half (46.5%) could not include an interpreter in telehealth visits. Barriers reported by telehealth users included concerns about limited patient access to technology (74.3%), home environment distractions (56.5%), preference for in-person care (53.6%), telehealth effectiveness (48.1%), workflow efficiency (42.2%), and cost/reimbursement (32.1%). Global DBP clinicians rapidly adopted telehealth and continued to have interprofessional practice while doing so, with the largest adoption occurring in HICs. Provider concerns about effectiveness and patient access to technology emerged as key organizational and patient barriers, respectively. Increased provider confidence in telehealth and its sustained use in the future depends on supportive regulatory policies and availability and use of measures to monitor quality and effectiveness.