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An Expert Guide to Pediatric Virtual Well Visits

By June 23, 2020 No Comments

During a time when congregating in a waiting room is deemed unsafe yet children still need ongoing and preventative care—pediatricians are turning to virtual well visits as the answer. We hosted a webinar in which we asked industry-leading pediatricians Jeanne Marconi, MD, Russell Libby, MD and Susan Sirota, MD how they’ve implemented telemedicine well visits in their own practices. Here’s what they had to say:

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The emergence of the COVID-19 pandemic has forced healthcare practices to transform in a matter of weeks. 

Perhaps one of the most transformational steps of all is the rise in telemedicine. Prior to the birth of the coronavirus, telemedicine was not a recommended option for pediatric virtual well visits. Now, it’s a viable option to accommodate patients, parents, and caregivers who are cautious and fear exposing themselves to the virus with an in-person visit to the pediatrician’s office. 

Here are some key takeaways from our Pediatric Virtual Well Visits Webinar, in which four pediatricians who are pioneering a new way to care for patients during COVID-19 share their secrets, best tips and strategies for telemedicine success. 

4-step strategy for successful virtual pediatric well visits

Mick Connors, MD, and Founder and CEO of Anytime Pediatrics, suggests looking at pediatric well visits as ongoing innovation rather than a one-and-done, rigid plan. He broke down a four-step strategy for pediatricians looking to get started. 

Plan. Create a project plan, and know your plans will evolve as you continue offering telemedicine as an option for patients. Designate a team lead, ensure physicians are well-trained to use any necessary technology, and communicate those changes to your staff. 

Do. Track your dates, dollars, and deliverables. Also make sure to consider necessary training, costs, and how to execute on key deliverables. Implementing new changes takes time, but make sure to set realistic goals as your practice adjusts. 

Study. Continually innovate, set goals and measure along the way. At first, your practice will be focused on simply building engagement, but make sure to track key performance indicators along the way. 

Act. Continually innovate based on the feedback of tracking KPIs. They will provide your team with real time visibility, allow you to become more self aware, and ensure you’re continually improving.  

Why should you consider pediatric virtual well visits?

  • To address the problems and gaps in care created by COVID-19. Russel Libby, MD, cited an initial hesitation to offer virtual well visits as a service—until COVID-19 left practices with few other options. In addition to the virus itself, his team dealt with a lack of PPE, patient cancellations, an end to elective surgeries, among other issues. His team integrated telemedicine prior to the pandemic and not only has it addressed these problems, but it’s also helped the practice adapt to changing times. 
  • To meet the needs of patients. Jeanne Marconi, MD, addresses the existing fear that many parents and caregivers have in stepping foot into a pediatrician’s office due to COVID-19. But just because there’s a pandemic, she says, doesn’t mean children should no longer have access to trusted medical care. Switching to pediatric virtual well visits eliminates the risk for exposure and meets them where they are within the safety of their own homes.
  • To adapt to change and innovate care for the future. Times are changing, and telehealth is one way for clinics to evolve along with the current situation and prepare for the future of pediatric medicine. 
  • To keep up with vaccination rates. Keeping children healthy with on-time immunizations is a must. Dr. Marconi says telehealth provides an opportunity for pediatricians to conduct pre-visits virtually, and then administer vaccines quickly in a patient’s vehicle while wearing appropriate PPE. 

Tips for conducting telehealth visits

As you virtually meet with parents, caregivers, and patients, there are a few measures to keep in mind. You may not be able to assess patients in-person, but you can overcome these limitations by preparing in advance. 

Keep these tips in mind as you conduct telehealth visits:

Encourage families to have basic medical equipment on-hand. Consider incorporating peripheral devices for at-home use in addition to the live video. By equipping families with just a few pieces of equipment, you can safely gauge height, weight, vital signs, oximetry readings, and more. Dr. Marconi and staff at the Center for Advanced Pediatrics put together a bag with these items for around $100, which includes the cost of a branded bag.

  • Measuring tape
  • Otoscope
  • Blood pressure cuff
  • Oximeter
  • Thermometer
  • Flashlight 

Pre-visit readiness. Collect vitals and growth measurements prior to your virtual visit. Instruct families ahead of time to: 

  • Sit in well-lit areas
  • Have any necessary tools available
  • Fill out questionnaires
  • Have a list of medications readily available

Preparing families ahead of time ensures an efficient visit for both patient and provider, says Dr. Marconi. 

Create a physical exam workflow. This ensures consistency and thoroughness throughout the visit, and it will optimize accuracy for all telewell visits you have scheduled. While there may be limitations for the virtual visit, what you can see includes:

  • General behavior and appearance
  • Growth chart
  • Vital Signs
  • HEENT
  • Skin
  • Musculoskeletal 
  • Part of neurological exam

Schedule follow-ups. At the end of each visit, schedule patients for any labs, upcoming immunizations, visual and hearing exams, and more. 

Document accurately. Susan Sirota, MD, and Chair of Pediatrust, recommends using language specific to the COVID-19 pandemic when documenting the telewell visit. Acknowledge limitations in your notes, and address locations of both clinicians and parent/patients. Make sure to answer the “who, where, and how” questions in your post-visit documentation. Finally, identify tools and any care gaps or additional screening that needs to be done.

Coding and Billing. Make sure your billing company is up-to-date on your practice’s current guidelines. Additionally, use well visit codes and include any additional separate identifiable issues (modifier -25). Tap into the AAP Telehealth Support Page and Coding for Telemedicine Services fact sheet for support.   

Established in 2016, Anytime Pediatrics is the only pediatric-specific telemedicine solution. Learn more about how to integrate pediatric telemedicine services into your clinic and browse resources on the Anytime Pediatrics blog

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