Well Child: Staying Healthy at Home With Telehealth Care

What to know before your child’s virtual doctor’s visit

We’re following recommendations to stay healthy at home, but bumps, scrapes and sick days still happen. Thankfully, it’s never been easier to see a doctor without leaving home. As health-care providers and families adapt to COVID-19 and social distancing recommendations, more medical visits are taking place remotely via telehealth (also called “telemedicine” or “virtual care”).

Prior to COVID-19, telemedicine was already trending; virtual visits were projected to increase 16.5 percent by 2023, according to a report by Market Research Future consultants. Then, the coronavirus pandemic hit, and telehealth surged. In March 2020, telehealth visits spiked 50 percent.

The growth of telehealth in pediatric health care is good news for busy parents, many of whom are now juggling work and home-based schooling, says Nawal Alkharouf, M.D., a pediatrician with Washington-based health-care provider Pacific Medical Centers. “One of the main benefits we’re seeing for telehealth is convenience, especially in times like these. If families don’t want to come into the clinic or can’t make it in, this is another way to care for their child’s health,” she says.

Virtual care works best with your regular doctor.
Although telehealth can work well in urgent-care scenarios or help people who don’t have a regular primary care provider, it works best in an established doctor-patient relationship, says Dr. Alkharouf. “Telehealth is most beneficial if it’s your own pediatrician or someone who has seen the child before, because that provides the greatest continuity of care,” she says.

Some conditions are better suited to virtual care than others.
Virtual visits work particularly well for certain types of pediatric care — for example, managing some chronic conditions, such as asthma and diabetes; follow-up appointments; behavioral health; and mild cold and flu symptoms. Other situations, such as a suspected ear infection or broken bone, warrant an in-person visit. “Telehealth doesn’t work for every condition or all situations. If the provider needs to look into the child’s ear to diagnose an ear infection, they’ll likely need to go in,” says Dr. Alkharouf.

You don’t need any special equipment (but some advance prep won’t hurt).
There’s no need to buy an otoscope, a special thermometer or any other medical equipment for a virtual well-child visit, says Dr. Alkharouf. But taking 10–15 minutes to prepare for an appointment paves the way for a productive virtual session. Check your email or your provider’s online patient portal for instructions, complete any screening questionnaires, update your child’s health history (including making a list of all specialists or other health-care providers your child sees and assembling any medications), fill in insurance and pharmacy information, and make a list of questions or concerns you would like to discuss with the doctor. In preparation for the visit, take basic measurements (height and weight, and head circumference for children age 2 and younger) and check vital signs (temperature, pulse rate).

Your provider still wants to ‘see’ your child.
“Telehealth” can be a misleading term, since most virtual visits include a video component. And even though your provider may be miles away, they still want to get a good look at your child. For video visits, find a quiet spot in the home with good lighting so your provider has a clear view of your child. “For babies and small children, placing your laptop or device on a bed can work well,” says Dr. Alkharouf.

You may still need an office visit.
A sick-child appointment (say, for a rash or pink eye) can probably be carried out completely online. But a well-child visit may have two components: Caregivers can complete screening questionnaires and other paperwork virtually, then come in later for a physical exam and vaccines. “A good physical exam is an important part of a well-child visit, so it is important to bring your child in,” says Dr. Alkharouf. “But the good news is that you don’t necessarily need to come in right away unless your child needs a vaccine right now. So, you could do the virtual component of the exam now and wait until the summer, once things have calmed down with the pandemic, to come into the office.”

Behavioral health care at home has special considerations.
Behavioral health care can work well via telehealth since it usually doesn’t require a physical exam and can be easily carried out via video phone or video chat. But virtual health care makes it harder for providers to ensure patient privacy, an essential component of behavioral health. “Privacy is a major concern for behavioral health care at home, especially for our adolescent patients,” says Dr. Alkharouf. “If a private bedroom isn’t an option, some families have their teenager do their virtual health care in their car, so [the teen] can have complete privacy.”

Even after social distancing ends, telehealth will keep growing, says Dr. Alkharouf. “PacMed just launched virtual pediatric care, and the response from parents has already been very positive. Parents appreciate that they can take care of their child’s health, keep them safe and save time.”