Utility of telemedicine in tracheostomy‐dependent children
Abstract Objectives Telemedicine can improve access to pediatric otolaryngology care by decreasing travel time and cost, and lowering the risk of viral transmission during the SARS‐CoV‐2 (COVID‐19) pandemic. This study aims to identify the clinical role and outcomes of telemedicine for tracheostomy‐...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-12-01
|
| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.937 |
| _version_ | 1798004194837266432 |
|---|---|
| author | Lilun Li Stacy Jo Kosuke Kawai Laura Yacovone Mary Jackmin Roger C. Nuss |
| author_facet | Lilun Li Stacy Jo Kosuke Kawai Laura Yacovone Mary Jackmin Roger C. Nuss |
| author_sort | Lilun Li |
| collection | DOAJ |
| description | Abstract Objectives Telemedicine can improve access to pediatric otolaryngology care by decreasing travel time and cost, and lowering the risk of viral transmission during the SARS‐CoV‐2 (COVID‐19) pandemic. This study aims to identify the clinical role and outcomes of telemedicine for tracheostomy‐dependent children before and during the COVID‐19 pandemic. Methods Retrospective chart review of 42 tracheostomy‐dependent pediatric patients who utilized telemedicine between October 2013 and April 2020 (pre‐COVID‐19), and 111 patients who utilized telemedicine between May 2020 and July 2021 (during COVID‐19) at a tertiary free‐standing children's hospital outpatient clinic. Results The majority of pre‐COVID‐19 telecommunication solely addressed tracheostomy stomal concerns as compared with during COVID‐19 (99% vs. 3%, p < .001), while telecommunication during COVID‐19 was mainly used for routine follow‐up as compared with pre‐COVID‐19 (99% vs. 0%, p < .001). Telemedicine visits during COVID‐19 were significantly less likely to result in the need for in‐person office visits as compared with those pre‐COVID‐19 (4% vs. 22%; p < .001). There was no significant difference in urgent emergency department (ED) evaluation following telemedicine pre‐ and during COVID‐19 (16% vs. 11%). The most common reasons for ED presentation both pre‐ and during COVID‐19 following telemedicine visit included respiratory distress, dislodged tracheostomy tube, and tracheostomy bleeding. Conclusion The clinical role of telemedicine has evolved from problem‐based evaluation to routine follow‐up during the COVID‐19 pandemic. Although telemedicine can decrease the need for in‐person office evaluation of routine tracheostomy concerns, respiratory complications and tracheostomy bleeding still require urgent in‐person ED evaluation. Level of evidence Level 4. |
| first_indexed | 2024-04-11T12:20:57Z |
| format | Article |
| id | doaj.art-e93fb566ba7143e98c9131cda16111df |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-04-11T12:20:57Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-e93fb566ba7143e98c9131cda16111df2022-12-22T04:24:06ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-12-01761751175510.1002/lio2.937Utility of telemedicine in tracheostomy‐dependent childrenLilun Li0Stacy Jo1Kosuke Kawai2Laura Yacovone3Mary Jackmin4Roger C. Nuss5Department of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USADepartment of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USADepartment of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USADepartment of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USADepartment of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USADepartment of Otolaryngology and Communication Enhancement Boston Children's Hospital Boston Massachusetts USAAbstract Objectives Telemedicine can improve access to pediatric otolaryngology care by decreasing travel time and cost, and lowering the risk of viral transmission during the SARS‐CoV‐2 (COVID‐19) pandemic. This study aims to identify the clinical role and outcomes of telemedicine for tracheostomy‐dependent children before and during the COVID‐19 pandemic. Methods Retrospective chart review of 42 tracheostomy‐dependent pediatric patients who utilized telemedicine between October 2013 and April 2020 (pre‐COVID‐19), and 111 patients who utilized telemedicine between May 2020 and July 2021 (during COVID‐19) at a tertiary free‐standing children's hospital outpatient clinic. Results The majority of pre‐COVID‐19 telecommunication solely addressed tracheostomy stomal concerns as compared with during COVID‐19 (99% vs. 3%, p < .001), while telecommunication during COVID‐19 was mainly used for routine follow‐up as compared with pre‐COVID‐19 (99% vs. 0%, p < .001). Telemedicine visits during COVID‐19 were significantly less likely to result in the need for in‐person office visits as compared with those pre‐COVID‐19 (4% vs. 22%; p < .001). There was no significant difference in urgent emergency department (ED) evaluation following telemedicine pre‐ and during COVID‐19 (16% vs. 11%). The most common reasons for ED presentation both pre‐ and during COVID‐19 following telemedicine visit included respiratory distress, dislodged tracheostomy tube, and tracheostomy bleeding. Conclusion The clinical role of telemedicine has evolved from problem‐based evaluation to routine follow‐up during the COVID‐19 pandemic. Although telemedicine can decrease the need for in‐person office evaluation of routine tracheostomy concerns, respiratory complications and tracheostomy bleeding still require urgent in‐person ED evaluation. Level of evidence Level 4.https://doi.org/10.1002/lio2.937COVID‐19pediatric otolaryngologytelemedicinetracheostomy |
| spellingShingle | Lilun Li Stacy Jo Kosuke Kawai Laura Yacovone Mary Jackmin Roger C. Nuss Utility of telemedicine in tracheostomy‐dependent children Laryngoscope Investigative Otolaryngology COVID‐19 pediatric otolaryngology telemedicine tracheostomy |
| title | Utility of telemedicine in tracheostomy‐dependent children |
| title_full | Utility of telemedicine in tracheostomy‐dependent children |
| title_fullStr | Utility of telemedicine in tracheostomy‐dependent children |
| title_full_unstemmed | Utility of telemedicine in tracheostomy‐dependent children |
| title_short | Utility of telemedicine in tracheostomy‐dependent children |
| title_sort | utility of telemedicine in tracheostomy dependent children |
| topic | COVID‐19 pediatric otolaryngology telemedicine tracheostomy |
| url | https://doi.org/10.1002/lio2.937 |
| work_keys_str_mv | AT lilunli utilityoftelemedicineintracheostomydependentchildren AT stacyjo utilityoftelemedicineintracheostomydependentchildren AT kosukekawai utilityoftelemedicineintracheostomydependentchildren AT laurayacovone utilityoftelemedicineintracheostomydependentchildren AT maryjackmin utilityoftelemedicineintracheostomydependentchildren AT rogercnuss utilityoftelemedicineintracheostomydependentchildren |