Direct-to-Consumer Virtual Visits: Is This the Next Generation Health-Care Delivery System for Pediatric Ophthalmology?
Ankoor S. Shah, MD, PhD; Heather Meyers, MBA; Christina Brown; Dylan Cahill; Aaron Farber; Jane Patrick;
Molly K. Porter; Caitlin Schumann; Gordon Massey, MBA
Boston Children’s Hospital and Harvard Medical School
Boston, MA, USA
Introduction: Virtual visits (VVs) connect the clinician to the patient through a live-interactive video system. This allows patients to access care from home or any convenient location. This study presents data on the feasibility of VVs in pediatric ophthalmic care.
Methods: We developed a Health Insurance Portability and Accountability Act-compliant video platform and used it to implement VVs across 5 pediatric services including neurology, cardiovascular surgery, ophthalmology, oral surgery, and pain in December 2016. We retrospectively reviewed quality metrics for the program and for ophthalmology as a subset.
Results: After 9 months, we completed 513 virtual visits. The overall patient rating was 9.2/10 with 95% stating that they would conduct another VV and 89% citing convenience as the major benefit. The overall provider satisfaction was 9.5/10 with 94% commenting that the VV was equally effective as an in-person visit. Ophthalmology completed 35 (7%) VVs comprising of 15 post-operative strabismus evaluations, 12 ocular surface and periocular post-operative conditions, 8 return patients (1 on hospice), and 1 new patient. In comparison to in-person visits, ophthalmology VVs saved >$13,440 and >140 hours of travel and wait time for patients.
Discussion: VVs are feasible and appealing in pediatric medicine. In pediatric ophthalmology, we have used them predominantly for delivering post-operative care, and these qualitative data are reassuring. However, data comparing outcomes between VVs and in-person visits are lacking.
Conclusion: VVs are feasible, intuitive, and will revolutionize healthcare delivery as long as we are careful to ensure patient safety with more studies.
References: Dorsey ER, Topol EJ. State of Telehealth. N Engl J Med. 2016 Jul 14;375(2):154-61. doi: 10.1056/NEJMra1601705