Perspectives of a Predominantly Marginalized Population on Telemedicine

ABSTRACT

Purpose of Study Telemedicine has become a common option for healthcare delivery in the post-COVID-19 era. There are advantages, but the barriers to care for children with medical complexity (CMC) and marginalized populations have not been well-described. This study assessed parental perception of telemedicine in the care of their children. Methods Used A REDcap survey was distributed to parents of hospitalized patients close to discharge to examine their attitudes regarding outpatient telemedicine with a focus on the post-discharge follow-up visit. Summary of Results: A total of 78 parents responded to our survey. A majority (58%) identified themselves as an ethnic minority. About 47% of parents completed college or postgraduate education;the rest had a high school diploma or some college education. Half (50%) of the parents reported a family income of <$100,000. Of the 78, 50% had used telemedicine previously, and a majority (76%) preferred in-person visits. Of those who belonged to a minority population, 80% preferred in-person visits after hospital discharge. Fifty-seven of the parents answered further questions about telemedicine and their child's medical complexity. Of these 57, 53% had a CMC, requiring specialized care and only 20% agreed or strongly agreed that it was difficult to take their child to in-person visits. Fifty-three out of the 78 parents provided a free text response about their thoughts on telemedicine visits. Common themes about advantages of in-person visits were a) preference for a physician's physical exam b) in-person visits were more personal and facilitated clearer communication and c) in-person visits provided more accurate? care compared to telemedicine (See Figure). Internet or computer access as a barrier was only mentioned by 3 parents. The main advantage of telemedicine mentioned was convenience. Conclusion(s) Our study shows that most parents prefer in-person visits, especially after hospital discharge. Our results may not apply to other populations as most of our patients were medically complex and belonged to a minority population. To increase parental support of telemedicine, techniques to improve family confidence in visual assessment and communication are required. Larger studies are needed to identify the needs of patients and families with a focus on the child's medical needs.