MP53-17 FACTORS CONTRIBUTING TO EFFECTIVE TELEMEDICINE USE IN PEDIATRIC UROLOGY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP53-17 FACTORS CONTRIBUTING TO EFFECTIVE TELEMEDICINE USE IN PEDIATRIC UROLOGY Julia Finkelstein, James Rosoff, Regina Tham, and Caleb Nelson Julia FinkelsteinJulia Finkelstein More articles by this author , James RosoffJames Rosoff More articles by this author , Regina ThamRegina Tham More articles by this author , and Caleb NelsonCaleb Nelson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003301.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is limited knowledge of the effectiveness of telemedicine (TM) for management of pediatric urological conditions. With TM expansion, it is necessary to deliberately evaluate and establish its optimal role in pediatric urology. We sought to prospectively investigate clinician-determined efficacy of video visits (VVs) performed for pediatric urologic encounters at a single tertiary care children’s hospital. METHODS: After entering the diagnosis and submitting billing using a TM modifier, clinicians were mandated to select whether the VV allowed for: complete case management (CCM), suboptimal, but adequate, case management (SCM); or incomplete case management (ICM) necessitating an in-person visit. These categorizations were compared according to patient pathology: internal organ pathology (IOP), functional urological pathology (FUP) or external organ pathology (EOP). The data were also stratified by patient-centered variables, including age, sex, race, and insurance type, to assess their impact on VV efficacy. RESULTS: During the 4.5-month study period (5/18/22 - 9/29/22), 1,127 unique patients had a VV. Mean patient age was 8.4 years and 57.0% were male. Ninety-six percent, 3.3%, and 0.7% of VVs demonstrated CCM, SCM, and ICM, respectively. Approximately 88% of VVs were established patients and these TM patients were more likely to have CCM, compared to new patients (p<0.001). TM patients with IOP and FUP were more likely to have CCM, than those with EOP (99.0% and 96.9% vs 87.1%, p<0.001). Older patients also had a higher likelihood of CCM (p=0.03). Meanwhile, Black, non-Hispanic patients were significantly less likely to have CCM (85.3%, p=0.02). Patient sex and insurance type did not impact the VV efficacy. CONCLUSIONS: Overall, TM is very effective for the management of pediatric urological patients. Our findings suggest that older established patients with IOP or FUP may be better suited for TM. Expanding on this data will allow for the development of best practice guidelines surrounding TM use in pediatric urology. To implement more inclusive strategies, further evaluation is necessary to understand why certain communities have less effective virtual care. Source of Funding: We have grant funding from our malpractice insurer, CRICO (Risk Management Foundation of the Harvard Medical Institutions), to investigate the safety, efficacy and equitability of telemedicine use in pediatric urology © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e718 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Julia Finkelstein More articles by this author James Rosoff More articles by this author Regina Tham More articles by this author Caleb Nelson More articles by this author Expand All Advertisement PDF downloadLoading ...