Abstracts

Rationale: Epilepsy is the most prevalent pediatric neurologic condition, and is associated with high rates of comorbid conditions. For patients requiring multidisciplinary care and frequent follow-up, traveling to a tertiary medical center for subspecialty care can be expensive, time-consuming, and physically burdensome. Telemedicine has the potential to overcome barriers in accessing high-quality epilepsy care. Our objective was to evaluate patient satisfaction with telemedicine (video-call) appointments for follow-up pediatric epilepsy care. Additionally, we evaluated whether telemedicine appointments are a viable alternative to in person appointments, and their potential to help reduce financial and travel barriers in accessing care in a low-income population. Methods: Telemedicine consultations were completed for 61 patients receiving epilepsy care within the Division of Pediatric Neurology at Boston Medical Center between April 2017 and May 2018. Following the visit, patients were sent an email survey regarding quality and satisfaction with their telemedicine visit. Additional data collected included reason for visit, patient age range, primary language, and barriers to attending in-person appointments. For comparison, an analogous patient-satisfaction survey was administered to patients receiving in-person pediatric neurology care at Boston Medical Center. Results: To date, 27 (44.2%) individuals completed a satisfaction survey following their telemedicine appointment. Primary reasons for a visit included 1) medication follow-up, 2) urgent medical concern, and 3) care coordination. 25 (92.5%) surveys were completed by a parent or guardian. 17 patients completed satisfaction surveys for their in-person appointment.Almost all participants receiving telemedicine appointments reported they could see (96.3%) and hear (88.5%) their doctor very well during this visit. Participants reported saving an average travel time of 1 hour and 13 minutes (one-way), and only 14.8% participants reported needing to miss work or school to attend their telemedicine appointment compared to 82.4% of patients attending in-person appointments, who reported missing an average of 4.2 hours of school or work. Almost all telemedicine patients (96.3%) felt that their doctor was able to address their questions and concerns very well during the visit, and 100% of respondents would choose to meet with their doctor using video-call again. Conclusions: Telemedicine is a viable way to provide pediatric epilepsy care while reducing cost and travel burden for families in a low-income population. Families report high levels of satisfaction with telemedicine visit quality, and would choose to receive additional care using video-calling in the future. Implementation of telemedicine services should be considered in health centers serving populations of youth with epilepsy. Funding: The authors of this publication have research support from the Maternal and Child Health Bureau within the Health Resources and Services Administration, which is administered by the American Academy of Pediatrics.