P2.293: Ensuring Quality Transitions of Care from the Hospital to the Home Setting by Utilizing Virtual Visits

Background: Up to 2/3 of hospitalized children have issues with follow-up appointments, prescriptions, and other care following discharge. Few studies have examined the benefits of post-discharge telemedicine/virtual visits (VV) in pediatrics. In this multi-phase study, we created and implemented a VV program and assessed its impacts on care.

Methods: In the first phase (Nov 2017-Feb 2018), we administered an in-person anonymous survey to assess the needs of hospitalized patients’ families and referring primary care pediatricians (PCPs). These results informed our creation of patient selection criteria, patient/provider educational materials, and care coordination guidelines. In the second phase (Jun 2018-Nov 2018), we conducted a pilot trial of our VV program with 20 VVs and administered a post-visit survey to families and providers on their experience with the VV. In the third phase (Nov 2018-Feb 2020), the program was expanded before stopping due to the COVID-19 pandemic. In 2024, the program was restarted. Chart review of visits was conducted throughout phases 2 and 3 to assess impact.

Results: The initial phase of the study found that 24 (73%) of surveyed PCPs and 40 (85%) of surveyed families felt that VVs would be definitely or possibly useful, particularly for reviewing medication instructions, pending labs, and complex care transitions. In phases 2 and 3, 95 VV were accepted by patients with 60 completed. New appointments were made/coordinated in 12 (20%), new prescriptions were written in 10 (17%), new results reviewed in 20 (33%), and other orders were written in 7 (12%) VV, with an overall change in treatment plan for 34 (57%) patients.

Conclusion: VVs provide a tangible contribution to addressing post-discharge issues by confirming follow-up appointments, prescriptions, and orders; reviewing interval laboratory data; confirming discharge instructions, and providing additional reassurance to pediatric patients and families.