Access to Pediatric Epilepsy Care by Telemedicine in a Spanish-speaking Population
Abstract number :
2.359
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2022
Submission ID :
2204908
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Pamela McDonnell, MD – Children's Hospital of Philadelphia; Nicholas Abend, MD, MSCE – Children's Hospital of Philadelphia; Rahma Ali, Genetic counseling assistant – Children's Hospital of Philadelphia; Mark Fitzgerald, MD, PhD – Children's Hospital of Philadelphia; Alexander Gonzalez, MS, MBA – Children's Hospital of Philadelphia; Ingo Helbig, MD – Children's Hospital of Philadelphia; Michael Kaufman, MS – Children's Hospital of Philadelphia; Sara Molisani, MD – Children's Hospital of Philadelphia; Yessenia Ortiz, coordinator – Children's Hospital of Philadelphia; Craig Press, MD, PhD – Children's Hospital of Philadelphia; Julie Xian, Data scientist – Children's Hospital of Philadelphia
Rationale: During the COVID-19 pandemic, telemedicine became essential in providing pediatric epilepsy care. The transition from in-person to telemedicine visits was smooth for most patients, but we knew accessing telemedicine was burdensome for some non-English speaking families (Rametta S, et al. 2020). Here, we aimed to delineate telemedicine use in a Spanish-speaking population at a large tertiary pediatric epilepsy center. _x000D_
Methods: We used electronic medical record data to quantify rates of patient portal activation. We used the activation for a patient portal, which was required for telemedicine care, as a proxy measure for participation in telemedicine care. We assessed preferred language and interpreter use and performed chart review of patients seen by a Spanish-speaking provider.
Results: We quantified patient portal access across 82,533 patient encounters with around 2,751 encounters per month between October 1, 2019, and March 21, 2022. Manual review of 21 Spanish-speaking patient charts confirmed that patient portal access is a valid proxy measure for participation in telemedicine care; 80% of patients with patient portal access completed telemedicine visits. There was an increase in telemedicine access from 70% to 93%, but there were prominent differences in English- and Spanish-speaking families. Prior to the pandemic, there was a 5-fold difference in portal access rates between English (74%) and Spanish (37%) speaking families (OR, 5.44, p< 0.01). Spanish speaking family’s patient portal access rates grew an average of 6% overall, while English-speaking family’s grew around 1%. There was a gradual improvement, including a 19% difference after one year (April 2021) which improved to a 12% difference by 2022 although that difference was still significant (OR, 3.33, p< 0.01). Facilitated activation in the form of in person or phone instructions in Spanish (March 2020-May 2021) and laminated instructions in Spanish at time of check-in for visits followed by in-person help in Spanish if needed (June 2021-March 2022) had an effect on telemedicine access
Health Services (Delivery of Care, Access to Care, Health Care Models)