33. Telemedicine in Pediatric and Adolescent Gynecology

ABSTRACT

Background Telemedicine is broadly used to define medical care delivered remotely through telecommunication technology. This practice is recognized as an alternative strategy to traditional healthcare delivery with comparable health outcomes, and it has been rapidly expanded further in the context of the COVID-19 pandemic. While our clinicians have found telemedicine to be a helpful and innovative approach to medicine, its use specific to pediatric and adolescent gynecology has not been published. The primary outcome of this study was to determine the feasibility of virtual visits for ambulatory care in pediatric and adolescent gynecology. Methods This was a retrospective study on the use of telemedicine by the gynecology division at a tertiary pediatric hospital from January 1, 2020, to June 1, 2020. Video-based virtual visits through a hospital-supported software were conducted during the eligible time period. Patient demographics, visit diagnoses, and operational characteristics of the completed visits were obtained. The study received IRB approval. Results There were a total of 654 virtual visits for 614 patients. Ninety-one percent of patients were in-state (558/654), and the median age of patients seen was 17 years (range 0 – 37 years). Five hundred and two out of 654 visits were return visits (76.8%), 115/654 were new patient visits (17.6%), and 32/654 (4.89%) were post-operative follow-up. The median duration of a virtual visit was 12 minutes and 39 seconds (range 5 minutes to over 1 hour). The most common gynecologic diagnoses were dysmenorrhea/endometriosis (N=485), abnormal uterine bleeding (N=225), and pelvic pain (N=82). Visits were further assessed to determine if a follow-up in-person visit was needed within 90 days after the virtual visit. From the 654 virtual visits, 14 follow-up visits were in-person;5 were within 30 days from initial virtual visit, 6 were within 60 days, and 3 were within 90 days. The most common complaints that prompted an in-person follow-up were contraception administration (depot medroxyprogesterone, intrauterine device) (N=4), vulvovaginal symptoms (N=4), congenital anomaly exam (N=1), abnormal uterine bleeding exam (N=1), and an ovarian cyst (N=1). Conclusions Telemedicine is a feasible method for healthcare delivery in pediatric and adolescent gynecology with low rates of short interval in-person follow-up required. Virtual visits can be conducted for a range of patients with a variety of gynecologic conditions, upon initial presentation and follow-up.