Removing Barriers to Care for the Underserved: Provider and Patient Perception of Direct to Consumer Telemedicine

Purpose of Study: Lack of access to pediatric subspecialty care is a major barrier to pediatric health for underserved populations in the Washington DC, Virginia and Maryland area. Lack of access to transportation, long office wait times, and missed school and work are barriers that prevent access to subspecialty care. Direct to consumer (DTC) telemedicine provides this service to our underserved population by bringing care into their own home through use of computers, tablets, and smart phones. Methods Used: Structured interviews of parents and providers were performed prior to implementation of a subspecialty DTC telemedicine program for underserved children in Washington DC, Virginia and Maryland. Participating subspecialties included providers in neuropsychology, neurology, diabetes, and gastroenterology. Summary of Results: Pre-implementation structured interviews demonstrated a need for a more time-effective and convenient solution to the current model for subspecialty care. Parents reported telemedicine could save them time and cost while eliminating driving, parking, and waiting for an in-person appointment. Parents also reported home observation and management of certain conditions, such as feeding disorders, would reduce stress/anxiety. The two most positive aspects of telemedicine reported by providers were follow-up education in the families\u27 homes and coordination of multiple specialties/personnel in a single visit. Conclusions: Parents desire an expansion of DTC telemedicine subspecialty services. DTC subspecialty care in a patient\u27s home may improve parent satisfaction and eliminate current barriers that exist. This study was sponsored by a grant from The CareFirst BlueCross BlueShield Foundation