Pilot of a Home Telehealth Platform in a Pediatric OPAT Program

Abstract

BackgroundPatients discharged with outpatient parenteral or prolonged oral antibiotic (OPAT) require monitoring to ensure optimal clinical outcomes. Advances in technology have allowed novel approaches for clinical interactions. We sought to develop a new home telehealth platform for a subsection of pediatric OPAT patients.MethodsWe used an existing infrastructure developed by our hospital telemedicine program to pilot the electronic home visit. A process was established to create a virtual connection at a pre-designated time using a HIPPA-secured web-based platform. Clinic staff performed a pre-visit technology check. Electronic Medical Record (EMR) scheduling platforms were created and the parent was coached on how to download and execute the necessary software. A virtual clinic was established between provider and family. Documentation occurred in the EMR with specific language and modifier codes for billing accuracy identified by the telemedicine team. Patients were selected based on medical complexity and travel time greater than 2 hours to our institution.ResultsTwo pediatric OPAT patients completed the pilot in Spring 2017 for treatment of 1) CLABSI with retained line and 2) chronic ulcer with osteomyelitis. Three visits between the OPAT ID provider, located in her office, and the patient, located at home, were successfully piloted with video and voice. A routine clinic visit was conducted with a parent-driven physical exam. A clinical note was documented in the EMR with specific telemedicine templates. This platform also allowed for multi-disciplinary visits with a hospitalist and home health nurse to address a central line related issue with ID provider present. Total time for each visit was under 20 minutes.ConclusionWe were able to demonstrate feasibility and functionality of this novel platform to conduct a billable OPAT clinic visit in a patient’s home. Health system infrastructure was a necessary and vital component to execution of the virtual clinic. Specific patient groups may benefit from this provider-patient interface. The use of telemedicine in OPAT may serve as a new platform for improving provider efficiency, lowering health system costs, and achieving greater patient satisfaction.Disclosures All authors: No reported disclosures.