Abstract Details

Title Pediatric Neurology Patient Disparities in Use of and Access to Rapid Telehealth Implementation during the COVID-19 Pandemic

Topic Health Care Disparities

Presentation(s) P18 - Poster Session 18 (5:30 PM-6:30 PM)

Poster/Presentation
Number 11-006

Background

SCH serves a five-state geographic area comprising 27% of the United States’ landmass, of which 25% is rural. Prior to the COVID-19 pandemic, the Neurology department utilized telemedicine visits infrequently (0.001% visits). COVID-19 demanded rapid implementation of telehealth with variable demographic use. Utilization of telephone versus telemedicine visits may indicate populations at risk of a care gap with increased telehealth use.

Objective To compare telehealth (telemedicine (video) and telephone) utilization pre-COVID-19 (10/6/2019-2/29/2020) and during the COVID-19 pandemic (3/1/2020-5/1/2021) among the diverse patient populations served by child neurology clinics at Seattle Children’s Hospital (SCH).

Design/Methods We tracked telemedicine, telephone, and in-person neurology visit utilization based on race/ethnicity, English proficiency, insurance type, interpreter utilization, broadband status, area deprivation index (ADI), and zip code of residence. While broadband status, ADI, and zip code data included only patients from the state of Washington, other measures included all patients seen.

Results Prior to the pandemic, telemedicine was used primarily for remote patient populations with a higher frequency of Hispanic and non-English proficient household patients. During the COVID-19 pandemic, we found a trend toward increased telephone visit utilization for patients of Hispanic ethnicity (14.7% vs 6.9% overall), patients from non-English proficient households (18.5% vs 10.1% overall), and those who reside in a cluster of four zip codes in Eastern Washington (11.9% of all phone visits). Areas with less broadband access or a higher ADI utilized telephone visits more compared to telemedicine visits.

Conclusions Given Seattle Children’s Hospital’s long-term goal of increased telemedicine use to improve access to care for underserved populations, further interventions are necessary to close the access to care gap for patients and families who reside in areas with lower broadband internet access, possess limited socioeconomic resources, Hispanic families, and those with limited English proficiency.

Authors/Disclosures
Lindsey Morgan, MD (Seattle Children's Hospital) PRESENTER	The institution of Dr. Morgan has received research support from NIH. The institution of Dr. Morgan has received research support from PERF.
Payal B. Patel, MD	The institution of Dr. Patel has received research support from National Institute of Health. The institution of Dr. Patel has received research support from AHRQ. Dr. Patel has received personal compensation in the range of $0-$499 for serving as a Author with MedLink Neurology.
	No disclosure on file
	No disclosure on file
Edward J. Novotny, Jr., MD, FAAN (Seattle Children'S Hospital)	No disclosure on file
Mark Wainwright, MD, PhD, FAAN (Division of Neurology Seattle Childrens Hospital)	Dr. Wainwright has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sage Therapeutics.