(1070) Utilization of Telemedicine in Pediatric Otolaryngology: A Tertiary Care Center’s Experience

Introduction: Telemedicine recently demonstrated exponential growth and has the potential to increase access to care for disadvantaged groups. We sought to evaluate our experience with telemedicine to explore factors that may yield the optimal pediatric otolaryngology telemedicine visit candidate.

Methods: A retrospective cohort of consecutive patients from January 2023 to December 2023 with a completed telemedicine visit in pediatric otolaryngology at our tertiary children’s hospital was reviewed. Exclusion criteria were no shows and cancelled appointments or appointments not performed by a physician. Sociodemographic factors, comorbidities, visit type, and surgical recommendations were collected.

Results: 132 patients (56.8% males and 43.2% females; median age 7 years, range 1-28 years) were included. 114 (86.4%) patients identified as White, 10 (7.6%) were Black, 2 (1.5%) were Asian, and 6 (4.6%) did not disclose their race. For the type of visit, there were 42 (31.8%) new and 90 (68.2%) return. Chief complaints included sleep disorder breathing (SDB) (72, 54.6%) and recurrent tonsillitis (11, 8.3%). 11 (8.3%) were post operative appointments and 38 (28.8%) included multiple chief complaints. Noncomplex patients (≤2 diagnostic codes) comprised 95 (72.0%). In the 122 ** visits, surgery was recommended for 62 (50.8%). 55 of the recommended 62 procedures were completed; the most common procedures were tonsillectomy ± adenoidectomy (n=46) and bilateral myringotomy with tubes (n=8). Only 3 required in person exam prior to surgery. The median time from telemedicine visit to surgery was 3 (range 0-12) months.

Conclusions: The use of telemedicine in a busy pediatric otolaryngology tertiary care center allowed for the provision of care for SDB and recurrent tonsillitis in non-complex pediatric patients. No patient was seen for ear complaints alone, reiterating the challenge posed to this area secondary to difficult telemedicine ear examination. Future directions involve comparisons with no show and in-person visits to create a decision tree to identify the most appropriate telemedicine candidates.