JMIR Publications

ABSTRACT

Background:

Prior to the COVID-19 pandemic, in-clinic visits were the standard of care for paediatricians at our centre. At the pandemic onset, virtual care (VC) was adopted at an unprecedented scale and pace.

Objective:

This quality improvement (QI) initiative explored the VC experience of paediatricians during the pandemic by determining factors that supported and challenged VC adoption.

Methods:

The Donabedian model was used to evaluate VC experience via online survey. All department-affiliated paediatricians (including generalists and subspecialists in surgery and medicine) were invited to participate via email. Results were collated and descriptive statistics were applied.

Results:

Of 195 paediatric physicians, 63 responded (response rate 32.3%, mostly subspecialists at academic centres (84.1%)). Pre-pandemic, only 30.1% used VC and saw <10% of patients virtually. During March-May 2020, 93.8% transitioned to VC; with >50% seeing over 75% of patients virtually. Telephone and OTN were the platforms most used (77.4% and 64.2% respectively). VC experience was considered positive (73.6%), and only 18.8% found VC difficult to use despite 41.5% reporting technical difficulties. Challenges included lack of physical exam, lower patient volumes, and poor patient VC etiquette. Regardless of demographics, 96.4% would continue VC, ideally for patients who live far away (90.2%) and for follow-ups/established diagnoses (73.1%).

Conclusions:

Transition to VC during COVID-19 was associated with challenges but also positive experiences. Willingness among paediatricians to continue VC was high. Paediatricians’ VC experiences at our centre could be improved with patient education and targeting select populations. Future research is needed to improve practice efficiency, and to inform regulatory guidelines for VC. Clinical Trial: Research ethics exemption was granted by The Office of Human Research Ethics (OHRE) on behalf of Western University's REB.