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Multicenter Study
. 2021 Jan;23(1):80-84.
doi: 10.1007/s43678-020-00048-w. Epub 2020 Dec 18.

Virtual care in the pediatric emergency department: a new way of doing business?

Sarah Reid  1   2 , Maala Bhatt  3   4 , Roger Zemek  5   3 , Sandy Tse  5   3
Affiliations
Multicenter Study

Virtual care in the pediatric emergency department: a new way of doing business?

Sarah Reid et al. CJEM. 2021 Jan.

Abstract
in English, French

Objectives: To understand the feasibility, utilization rate, and satisfaction of the first Virtual Pediatric ED (V-PED) in Canada.

Methods: We conducted a prospective cohort study examining the feasibility and impact of virtual care as an adjunct to in-person emergency care at a tertiary pediatric hospital from May to July 2020. Children (< 18 years) from Ontario and Quebec seeking V-PED care were included. A secure, encrypted, video platform within the hospital's electronic medical record was used. Caregivers self-determined appropriateness of V-PED using a standardized online triage questionnaire to request their appointment. The V-PED is directly launched from the patient's chart and the family joins the portal via hyperlink. Outcome measures included the number of V-PED visits, hospital admission rates, and caregiver satisfaction using a 10-item voluntary post-visit online survey.

Results: A total of 1036 V-PED visits were seen of which 176 (17.0%) were referred for further in-person ED assessment, and 8 (0.8%) required hospital admission. Of the 107 completing patient experience surveys (10% response), most respondents (69%) endorsed they "very likely" or "definitely" would have presented in-person to the ED if V-PED were unavailable. Overall satisfaction was rated as excellent (9 or 10 out of 10) in 87% of respondents.

Conclusion: Our novel V-PED is feasible, has high caregiver satisfaction, and can reduce the burden of in-person ED visits. Future work must ensure the safety of emergency virtual care and examine how to increase capacity and integrate V-PED within traditional emergency medicine.

RéSUMé: OBJECTIFS: Comprendre la faisabilité, le taux d'utilisation et la satisfaction du premier service d'urgence pédiatrique virtuel (V-PED) au Canada. MéTHODES: Nous avons mené une étude de cohorte prospective examinant la faisabilité et l'impact des soins virtuels comme complément aux soins d'urgence en personne dans un hôpital pédiatrique tertiaire de mai à juillet 2020. Les enfants (< 18 ans) de l'Ontario et du Québec cherchant à bénéficier d'une prise en charge par la V-PED ont été inclus. Une plateforme vidéo sécurisée et cryptée a été utilisée dans le dossier médical électronique de l'hôpital. Les soignants ont autodéterminé la pertinence du V-PED à l'aide d'un questionnaire de triage en ligne normalisé pour demander leur rendez-vous. Le V-PED est directement lancé à partir du dossier du patient et la famille rejoint le portail via un lien hypertexte. Les mesures des résultats comprenaient le nombre de visites de V-PED, les taux d'admission à l'hôpital et la satisfaction des soignants à l'aide d'une enquête en ligne volontaire en 10 points après la visite. RéSULTATS: Au total, 1036 visites de DEP-V ont été effectuées, dont 176 (17,0 %) ont fait l'objet d'une évaluation approfondie en personne aux urgences, et 8 (0,8 %) ont nécessité une hospitalisation. Sur les 107 répondants aux enquêtes sur l'expérience des patients (10 % de réponses), la plupart (69 %) ont déclaré qu'ils se seraient "très probablement" ou "certainement" présentés en personne aux urgences si la V-PED n'était pas disponible. La satisfaction globale a été jugée excellente (9 ou 10 sur 10) par 87 % des répondants. CONCLUSION: Notre nouveau V-PED est réalisable, donne une grande satisfaction aux soignants et peut réduire le fardeau des visites en personne aux urgences. Les travaux futurs doivent garantir la sécurité des soins virtuels d'urgence et examiner comment augmenter la capacité et intégrer la V-PED dans la médecine d'urgence traditionnelle.

Keywords: COVID-19; Emergency medicine; Pandemic; Pediatric; Virtual care.

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Conflict of interest statement

MB declares competitively funded research grants from Physician Services Incorporated (PSI) Foundation, CHEO Foundation and the Ontario Government. No commercial conflicts of interest to disclose. RZ declares competitively funded research grants from Canadian Institutes of Health Research (CIHR), Ontario Neurotrauma Foundation (ONF), Physician Services Incorporated (PSI) Foundation, CHEO Foundation, Ontario Brain Institute (OBI), and Ontario SPOR Support Unit (OSSU), National Football League (NFL), and Clinical Research Chair in Pediatric Concussion from University of Ottawa. No commercial conflicts of interest to disclose. SR and ST have nothing to disclose.

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