Telemedicine is Now Playing a Vital Role in Care Delivery

By Kristin Carlton, Director of Telemedicine Clinical Outreach, Children’s Health

When the world went into lockdown due to COVID-19 in early 2020, virtual care teams around the globe had to pivot immediately and find a way to continue to deliver care. Children’s Health in Dallas, the leading pediatric health care system in North Texas, sprang into action to ensure patients maintained ongoing routine appointments leading. This led to an increase in virtual care utilization by 2000%, ranging from ambulatory care, telespecialty programs, and bedside telemedicine; to direct-to-consumer virtual visits such as school-based telehealth at home and tele-behavioral health.

The Children’s Health Virtual Visit application helped bridge the care gap in the ambulatory clinics during the height of COVID-19. Once the Spanish version of the application was released, we could expand our reach even further to our Spanish-speaking population. Remote Patient Monitoring spiked with the need to keep the most vulnerable population home and avoid frequent ER or urgent care visits in non-urgent situations.

As we progress forward, health equity plays a crucial role in the planning and developing of our programs to ensure all patients, no matter what their social, economic, demographic, or geographic status is, have access to care.

The Children’s Health bedside telemedicine program was introduced in 2020 to protect vulnerable patients. The Virtual Care team set up more than 70 telehealth carts at the Children’s Health Dallas and Plano hospitals to be used in areas where patients are in isolation; limiting foot traffic, reducing PPE usage, and allowing a more positive patient experience. In addition, telemedicine carts have been included in the Emergency Room of both campuses to connect providers and nurses for care management.

Although the world slowed down, babies were still being born with complications. Those families seeking support were now able to virtually connect with our NICU team and specialist via our TeleFetal program. Also launched in the fall of 2020 was the nation’s first Neonatal TeleTransport program that enables better patient care with instant access, the ability to assess patients in real-time, gauge responses to treatment and make adjustments as needed prior to arriving in our NICU.

Now, as we begin to return to a semblance of normalcy, we are re-evaluating the needs of our patients, families, and health care providers to ensure our programs are in alignment. Instant access is now driving virtual care growth and quickly becoming the new normal, and we know telemedicine can improve patient engagement and satisfaction.

Thanks to telemedicine, we are able to virtually connect with the patients at any point in their health care journey or, as we call it, the virtual care continuum. For example, in our NICU, we have the ability to virtually connect with expecting parents via our TeleFetal program, or connect with a physician in a remote NICU via our TeleNICU program to allow a virtual assessment and determine baby requires a higher level of care. When our transport team goes to pick up a baby at an outside hospital, our neonatologist can virtually connect while the transport team is on-site at a different location and talk to the referring physician, assess the baby, and meet the parents to discuss an immediate plan of care. If needed, a neonatologist can virtually assess the baby while in route and adjust treatment based on real-time assessments. Once the baby is in our NICU, we are able to live stream at the bedside for family and friends. Suppose a parent is unable to be at the bedside for daily rounds. In that case, we have the technology to facilitate a virtual connection for external family members and encourage them to actively participate and ask questions regarding their baby’s care.  

The health care journey looks different for every patient and now we are able to provide quality care whether it is in person or virtually. As telemedicine becomes a staple in our health care system, it is important to remember not all patients have equal access to technology. As we progress forward, health equity plays a crucial role in the planning and developing of our programs to ensure all patients, no matter what their social, economic, demographic, or geographic status is, have access to care.

Telemedicine is now at the forefront and plays a crucial role in how we move forward in our care delivery. It is our responsibility as healthcare providers and virtual care leaders to be mindful when developing telemedicine programs. Now more than ever, there is a push for new technology. To succeed, we need to start by evaluating the process, identifying bottlenecks, and work on technology that can improve the process. This will quickly allow teams to measure the success of the program and encourage increased utilization. It is also our responsibility to understand when virtual care is not an option and identify alternate means of care. This is an exciting time in health care, and I am honored to be a part of an organization that embraces virtual care and health care innovation. I am amazed at how we continue developing programs that have a huge impact on our pediatric community and beyond. Telemedicine is a powerful tool and I look forward to watching how we continue to weave virtual care into the fabric of health care.