391 - Parent perceptions of telemedicine for acute pediatric care

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 391
Publication Number: 391.314

Sarah K. Burns, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Janel Hanmer, University of Pittsburgh, Pittsburgh, PA, United States; Tamar Krishnamurti, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Tran Doan, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Kelsey Schweiberger, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Alejandro Hoberman, UPMC Children’s Hospital, Pittsburgh, PA, United States; Jeremy M.. Kahn, University of PIttsburgh, Pittsburgh, PA, United States; Kristin Ray, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States

Presenting Author(s)

Sarah K. Burns, MSW, LSW (she/her/hers)

Project Coordinator
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania, United States

Background: The addition of pediatric telemedicine among traditional care options poses new challenges and opportunities in decision-making for parents who are seeking acute care for their children.

Objective: We sought to examine parental expectations of telemedicine, contrasting telemedicine delivered in primary care versus commercial direct-to-consumer delivery.

Design/Methods: We performed a sequential mixed-methods study to examine how parents view telemedicine for their children’s acute care. First, we used semi-structured interviews to identify factors affecting parental interest in use of telemedicine. In a qualitative analysis of the interview transcripts, we applied an existing seven dimension framework of parental medical care-seeking. Second, we developed and fielded a national survey informed by the qualitative results, inquiring specifically about parental expectations of primary care telemedicine compared to commercial direct-to-consumer telemedicine. In a quantitative analysis of the survey results we used weighted logistic regressions to compare responses for each item across site of care

Results: Interview participants (n=40) described 28 factors that affected their interest in using telemedicine for their children. Generally, factors aligned with access and affordability (e.g., wait time, cost), increased interest in telemedicine, while factors aligned with perceived illness severity, child susceptibility and clinician quality (e.g., trustworthiness) decreased interest in telemedicine. Factors aligned with parental self-efficacy and site quality (e.g., privacy) were mixed in directionality. Interviewees also expressed differential interest in telemedicine for themselves versus their children. In survey responses (n=1206), perceptions of primary care and commercial direct-to-consumer telemedicine were generally similar for items aligned with access and affordability. In contrast, perceptions of primary care versus commercial telemedicine differed significantly for factors aligned with clinician and site quality. For example, 69.7% of respondents anticipated their children would be comfortable and cooperative with primary care telemedicine versus 49.7% with commercial direct-to-consumer telemedicine (p< 0.001).

Conclusion(s):

Parents had greater concerns about telemedicine quality than accessibility. Concerns about quality were less salient for telemedicine occurring within primary care than commercial settings. By better understanding parents’ current expectations of telemedicine, health systems can better design telemedicine initiatives to support family-centered care.