Pediatric Telemedicine
With everything else on pause during this time, it may seem like it’s worth putting your children’s doctor visits on hold as well. But pediatric offices across metro Atlanta are coming up with telemedicine practices and other solutions to continue seeing patients in a safe manner.
Atlanta Parent spoke with Dr. Kelly Wilburn from Dunwoody Pediatrics about telemedicine and how to continue to keep your child healthy during this time.
How is telemedicine helping pediatricians see patients during this time?
Telemedicine is allowing us to continue to connect with and care for our patients while maintaining social distancing and shelter-in-place guidelines.
What concerns can be solved through telemedicine, and when should families physically visit the doctor?
We are really screening most of our children by telemedicine first, and if we feel like we need to see them in person, we are bringing them into the office later that day for a visit. A lot of things can be accomplished as a telemedicine visit with some creativity and the help of our parents “assisting” us with the exam. For infants or older kids with persistent fevers or other concerns, some will need to come in for a physical appointment, so we can listen to their heart and lungs and check their ears to make sure we are making the right diagnosis. We are just asking our patients to call first and talk to a triage nurse, then we can help them decide the best way to proceed.
How can parents get the most out of the telemedicine visit?
Think of your telemedicine appointment just like a visit to the doctor, and try to have a quiet, distraction free place where you and your child can be for the visit. Before your visit, check to make sure your devices are charged, and make sure your camera and microphone are working. Our nurses are calling to walk parents through how to check basic vitals before our telemedicine visits. If you have a scale, weigh your child before the appointment, and if your child is taking any medicines, have those handy as well. Just like with your regular doctors appointments, have a list of questions and notes ready, so we can answer them while we are online with you.
Why should kids continue to go to their wellness check-ups?
There are several reasons that kids of all ages should keep their wellness checkups, aside from us monitoring growth and nutrition. For kids that need vaccines, especially those under the age of 2, it is really important to keep them on schedule. The AAP’s vaccine schedule was created to maximize protection against vaccine preventable illnesses in our most vulnerable population. If we get off schedule with these vaccines, we run the risk of seeing a resurgence of illnesses like measles or pertussis (whooping cough), which can be especially dangerous in this age group. For toddlers and preschoolers, a large portion of the wellness checkup is dedicated screening for developmental and language disorders, such as autism. As pediatricians, we know that early intervention is crucial for treating these disorders, so keeping our wellness screenings on time will help us intervene early when necessary. Finally, for school-aged kids and adolescents, as they navigate this pandemic while socially distancing from classmates, teammates and friends, we are seeing an increase in anxiety and depression. We can help assess for these mental health concerns while addressing their overall health at these wellness checkups.
What precautions are you taking when families come in for an in-office visit?
We are seeing our well visits exclusively in the mornings and reserving our afternoons for telemedicine visits and in-person sick visits. All patients are brought immediately to an exam room, so the waiting room virtually does not exist. Many pediatric offices are doing this same thing. Parents can also wait in their car, and we will text them when their exam room is available if for some reason there is a wait when they arrive. Our staff have temperature screened and have to complete a symptom checklist as soon as they report to work. We are vigilant about wearing appropriate PPE for all visits with patients. We are cleaning all office surfaces and equipment in between each patient, and washing our hands like crazy!
What should parents know about coronavirus and how it spreads?
Coronavirus spreads mostly through respiratory droplets from people who are sick with the disease. It is important to know that some people will not show signs of illness in the early stages of infection. It would be rare for these droplets to spread person to person at a distance of six feet or greater, which is where the “6 foot” rule comes when we talk about social distancing. Wearing a mask also helps prevent these respiratory droplets from spreading. Another way you can get sick from COVID-19 is by touching a surface that has the virus on it, and then touching your nose, mouth or eyes. This is why aggressive, frequent hand washing (20 seconds at a time) and wiping down surfaces with disinfectant is so important.
What are the general recommendations you’re giving patients now for keeping their kids healthy?
Kids thrive when they are able to maintain a consistent schedule, including time for school work, time for physical activity, time to be outside and time to be creative. Help your child maintain normal, healthy bedtime routines, and eat a healthy, varied diet. Help them stay connected with friends and extended family members through video apps, like FaceTime, so they feel less isolated.
What would you tell parents who are not being as strict with social distancing and allowing their kids to play in the neighborhood?
This is a time to lead by example. Social distancing is going to be our best bet at slowing the spread of COVID-19. We are starting to understand that COVID-19 may spread from asymptomatic people, or people who are not yet having symptoms of infection. It is definitely time to avoid playdates and public places, such as playgrounds. There are lots of ways for adults and kids to be creative and interact with friends and still maintain social distancing guidelines. We have seen families do virtual playdates, watch virtual museum tours and reinstitute family game nights. We have seen neighborhoods do scavenger hunts and sports teams do social media challenges. Last night when I was walking my dogs, a child in my neighborhood was playing the violin on her front porch hosting a concert for those that were walking by and enjoying the fresh air. Think of it as being physically distant but socially connected—there are lots of ways to innovate and still “be” together.
What other advice do you have for parents during this time?
Make time to talk with your children and answer questions they have. Provide truthful, age appropriate answers to their questions. Keep information simple, and monitor your own emotions when discussing COVID-19. Our tone of voice when we talk to our kids can often be as important as what is being said. Reassure them that healthcare workers, scientists and others are working hard to keep them healthy and safe. Teach them to respect and thank other essential workers. Focus on things they can do, like hand washing, covering their cough or sneeze and avoiding touching their face to slow the spread of illness. Pay attention to what children see or hear on television or online, and point out positive stories of people helping one another or recovering when you see them!
Virtual Visits to the Doctor
Here are some of the pediatric offices instituting telemedicine and preventative protocols to continue seeing patients in a safe manner:
- Atlanta Children’s Clinical Center is treating some minor illnesses and behavioral concerns with telemedicine.
- Briarvista Pediatrics is offering telemedicine visits.
- Children’s Healthcare of Atlanta uses telemedicine to connect your child to specialists. Only one visitor is allowed per patient.
- Children’s Medical Group is able to see patients through telemedicine for some complaints that do not require a hands-on evaluation. They’re implementing different entrances for sick and well patients, waiting in your car until your appointment, making online payments and more.
- Children’s Wellness Center is seeing patients through telemedicine visits with Anytime Pediatrics.
- Cobb Pediatrics is able to see certain conditions with telemedicine. They have also implemented scheduling changes, cleaning regimens and pre-screening of patients and their household members.
- Dunwoody Pediatrics has telemedicine services, is seeing well patients in the morning, sick patients in the afternoon and have a no waiting room policy.
- Kennesaw Pediatrics can take care of certain concerns with a telemedicine visit. They have also implemented the following changes: no walk-in patients, performing well kid visits in the morning and sick kid visits in the afternoon, the Newborn Center is in a separate section of the building, curbside check-in, pre-screenings and asking that everyone over the age of 2 wears a mask.
- Northside Pediatrics is able to treat some concerns with telemedicine. For in-person visits, well child appointments are in the morning with sick appointments in the afternoon, walk-ins are not allowed, the number of people in the office is limited, and there’s less time in the waiting room.
- Omega Pediatrics has transformed to a telemedicine first clinic. Newborn babies are being treated at a specific time, so there is minimal contact with other patients and families, and they are asking for parents who feel ill to not come into the office.
- Pediatric Associates has telemedicine appointments, and they are doing well child check ups in the morning and sick visits in the afternoon. They request sick visit patients remain in their vehicles, and they are also doing some car visits for sick patients.
- Pediatric ENT of Atlanta can see your child through telemedicine visits. They are also screening patients and families for travel and possible exposure, not seeing patients with fevers, allowing two visitors into the room with the patient, disinfecting waiting areas hourly and waiting in the hallway or in your car before the appointment.
- Piedmont Pediatrics has telemedicine appointments, well child visits in the morning, sick visits in the afternoon and are limiting the amount of time in the waiting room.
- Sunshine Pediatrics is offering telemedicine visits, and they have changed their hours.
- Tri-County Pediatrics has telemedicine appointments with Anytime Pediatrics, and their hours have changed. Patients will also be screened, and well visits will be held in the morning with sick visits in the afternoon.
- Urban Family Practice has telemedicine visits, a separate check-in area for well visits, pre-screenings and the opportunity for a remote check-in process.
- WellStar is offering online care and virtual house calls.
- West Atlanta Pediatrics has telemedicine appointments, changed their office hours, seeing well patients in the morning and increased cleaning and sanitizing measures.
- West Vinings Pediatric Group offers telemedicine visits, screening all patients, asking that only one parent accompanies the child and are not accepting walk-in visits at this time.