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Phone and video visits can offer timely care for kids

A recent Kaiser Permanente study finds virtual care can be a good option, but it doesn't always replace an in-person visit.

A phone or video visit can often be the fastest and easiest way to get medical care for a child. But do these visits get kids the care they need?

Kaiser Permanente researchers conducted a study to answer that question.

They found that phone and video visits often meet the needs of many kids and parents. But they can’t always replace seeing a doctor in person.

“In-person visits may be more important for children because many kids can’t explain how they are feeling,” said Scott Casey, MD, MS, an emergency physician in Kaiser Permanente Northern California, who led the study. “An in-person exam is important for the diagnosis of common childhood infections.”

The study was recently published in JAMA Health Forum. It included more than 780,000 primary care visits for children at Kaiser Permanente in Northern California. The study is the largest to date to look at children who had care through a phone or video visit.

The study found that 1 in 10 children needed an in-person visit after their phone or video visit. Nearly half of these in-person visits took place within 1 or 2 days of the phone or video visit.

“We need to help our members understand when a phone or video visit is the best choice for a child’s care,” said Dan Parry, MD, a pediatrician for Kaiser Permanente in San Rafael and regional medical director of Desktop Medicine. “Office visits are very helpful if a child has ear pain or certain lung problems, like pneumonia or asthma. But often I can make a correct diagnosis without doing an in-person exam. I’ve had parents tell me they are grateful that I can determine how their child is doing by phone or video so that they don’t have to leave their home.”

The study found that about the same number of kids had to be hospitalized after a phone or video visit as they did after an in-person visit.

“It should be reassuring to patients and doctors that phone and video visits are not making our emergency departments more crowded or leading more kids to be hospitalized,” said Dr. Casey.

Since 2016, Kaiser Permanente members in Northern California have been able to choose a telephone, video, or in-person appointment for primary care. Previous Kaiser Permanente studies have looked at the use of telemedicine by adults. This study is the first to focus on pediatric patients.

“Phone and video visits are very popular with patients, and they want it to be an option,” said senior author Mary Reed, DrPH, a DOR research scientist. “Our study supports its use, but also shows that for kids, in some instances, in-person visits are needed.”

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