Telehealth Expands Access to Pediatric Physiatry Care

In California’s rural towns, telehealth is emerging as a potential solution to the shortage of pediatric physiatrists—physicians who treat disorders of the bones, muscles, joints, brain, and nervous system. These physical medicine and rehabilitation specialists, or PM&R specialists, play a crucial role in patient care by supervising physical and occupational rehabilitation therapies, recommending medical equipment, and identifying children who may require surgical procedures.

However, when insurance companies refuse to cover the time required for physicians to travel to rural areas—which can be more than 100 miles from the physician’s original site—the scarcity becomes an even greater barrier to care.

Telehealth appointments are being investigated by UC Davis Health researchers as a potential substitute for in-person physician visits. The study and report was published in the journal Academic Pediatrics. The efficacy of telemedicine for kids with cerebral palsy enrolled in the California Children’s Services Medical Therapy Program was the particular focus of the study. Nearly 23,000 children with special health care requirements receive comprehensive medical care from the program’s network of multidisciplinary school-based care clinics.

Three models of care were assessed by the study:

• Conventional, in-person visits with physicists
• hybrid visits, in which a physical therapist visited the patient in person and physiatrists led the examination from a distance
• Virtual visits, in which parents conducted the physical examination while being remotely viewed on a computer screen by healthcare professionals including physicists and physical therapists

The study found that by offering a more affordable and patient-centered care model than in-person visits, hybrid visits could be a good way to extend the limited resources of physiatry in the state and rural areas across the nation.

“In rural communities, the likelihood that [these kids] are going to see a pediatric rehabilitation doctor, a physiatrist, is based upon the distance that they live from a special care center or tertiary care medical center,” said Loren T. Davidson, a clinical sciences professor and physician at UC Davis Health and one of the study researchers. “Too often, rural families of children with special physical needs must choose between traveling long distances to seek care or forgoing care.”

Exams that are hybrid can be a good substitute for in-person physiatry exams
Between the three distinct care models, the researchers did not find any variations in the parents’ experiences or their level of satisfaction with the quality of care.

The in-person and hybrid forms of care were preferred by the physiatrists and therapists. In comparison to the other two care models, they gave the all-virtual form of care a poorer rating for parent education and confidence in the quality of care. Nonetheless, the level of satisfaction among physiatrists and therapists about the quality of care for both in-person and hybrid visits was similar. Additionally, they calculated that the hybrid appointments would save physiatrists’ travel expenses by $100 per visit, on average.

“This study demonstrated that a hybrid model of care could be used to expand access to pediatric physiatry care in California and, potentially, around the nation,” said Sarah Haynes, UC Davis Health epidemiologist and the study’s first author. “These findings are important and relevant for regions where few pediatric physiatrists serve geographically large areas and access to specialty care may be limited.”

Source Link: UC Davis Health