How telehealth varied across subspecialties in the pandemic

As life changed dramatically with the onset of the COVID-19 pandemic, so did the way people access care, leading many practices and patients to turn to telecare. A recent report examines how telehealth varied across pediatric subspecialties and whether its use led to changes in no-show rates and addressing inequalities in access.1

The researchers looked at 8 major pediatric medical groups in California that had agreed to pool their telecare use for 11 subspecialties from January 2019 and December 2021. A visit was defined as delivered by a physician who treated primarily children. The medical groups include the largest pediatric hospital in California and a medical system that covers the largest geographic region in the state.

In 2019, the 8 medical groups had 1.8 million visits with 549,306 unique patients under the age of 18. In this group of patients, 250,329 used Medicaid and 72,928 preferred to use a language other than English during their visits. From May 2020 to April 2021, telehealth visits ranged from 6% to 29% of total visits among the subspecialties that made less use of telehealth, such as cardiology, dermatology and orthopedics. In the subspecialties with a higher percentage of telecare, such as genetics, neurology and endocrinology, the total number of telecare visits ranged from 38.8% to 73.0%. Telecare visits remained stable from May 2020 for some subspecialties, especially those with lower overall use. Although no-show rates increased slightly for both lower telehealth use subspecialties (9.2% to 9.4%) and higher telehealth use subspecialties (13.0% to 15.3%) from prepandemic rates, the changes not statistically significant. after adjusted differences (difference, 2.5 percentage points; 95% CI, -1.2 to 6.3 percentage points; P = 0.15).

The researchers concluded that there was a high degree of variability in how subspecialties adopted telehealth. They believe that understanding this variation can be used to create future telehealth policies for pediatrics.


1. Uscher-Pines L, McCullough C, Dworsky M, et al. Use of telecare in pediatric subspecialties before and during the COVID-19 pandemic. JAMA Netw Open. 2022;5(3):e224759. doi:10.1001/jamanetworkopen.2022.4759

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