ABSTRACT
Background: Telehealth and health outreach facilities evolved as an integral component of healthcare delivery during COVID-19 pandemic;digital healthcare tools such as Virtual Clinics (VCs) enterprise along with outreach facilities adapted for uninterrupted healthcare delivery. Pediatric Non-Malignant Blood Disorders (NMBDs) section at King Faisal Specialist Hospital and Research Centre, Riyadh is a tertiary referral center for patients with bleeding disorders. Aim(s): To maintain access to care facilitating comprehensive care through physician consults, laboratory investigations and blood products supply Methods: Ambulatory care visits amongst children (<=14 years) collected and dashboard created utilizing REDCap for tracking visits (in-person and virtual) during the pandemic (April'2020 to April'2022). Result(s): Total of 7610 visits on 4610 patients identified with 72% (5520) in-person and 27% (2100) virtual visits;increase in virtual visits by 328% (490 visits) observed while comparing 12 month period prior to the COVID-19 pandemic ;in-person visits decreased by 15% (6493 visits) with an overall increase of 10% in ambulatory care visits, indicative of substitutive care delivery mode. Majority of virtual visits observed amongst Hemoglobinopathies, 45%, Bone Marrow Failures, 36% and bleeding disorders, 19%;with an average of 2.0 virtual visits per patient observed. Amongst bleeding disorders majority of the cases were Hemophilia, 40% (87);Von Wille Brand, 30% (65);Rare bleeding disorders, 21% (46) and Glanzmann thrombasthenia 9% (21).Combination of telehealth and health outreach resulted in timely and uninterrupted laboratory result reviews, medication refills and dental referrals and factor-replacement products were delivered in collaboration with outreach -satellite pharmacies. Conclusion(s): In our experience, integrating telehealth in alliance with regional outreach facilities found effective in maintaining continuity of care, demonstrating an unexpected prospect in the face of adversity. We plan to continue virtual care to resolve patient access, clinician shortage and geographic disparities while supporting the National Healthcare Transformation Program driven by the Saudi Vision 2030.