I responded by burping back “thank you.” That would never have happened in the office. She whispered in her mom’s ear for permission and then proceeded to burp the alphabet at me while the dog barked hysterically. I asked the girl to share with me something she had learned recently or was proud of. I had a checkup with a 5-year-old girl, her mom, and their new dog. That’s now part of my core connection with him. I learned that one parent I’ve known for a long time was an amazing artist he took me on a tour of his house showing me all his paintings. Gizzi: What their homes look like, what level of chaos might be going on, whether they have pets, for example. Q: What have you learned about your patients and families by seeing their homes?ĭr. Our clinicians can also use opportunities when they interact with patients to get them set up technologically in anticipation of a future video visit. We provide a cellular-enabled iPad for patients who don’t have smartphones or computers. We’re doing this now in the adult population, but we could certainly consider doing this for our pediatric patients. We have also embarked on some pilot projects to bring the technology to our patients. Lee: We recognize this as an issue, yet access to technology continues to improve. Edward Lee, MD Q: What about families that may have technical or other barriers to video care?ĭr. In fact, when teens are in a confidential space in their own home, they are often more open with us. We’ve discovered that teenagers can be very effectively seen by video. School-aged kids are much more cooperative and will share their histories. Toddlers can be a little bit more challenging because they may not be as cooperative on video, though we can definitely observe something the parent is concerned about. Video visits also can be a great option for some newborns as long as there’s a scale at home for the baby so we can track growth. Gizzi: In pediatrics, some video visits don’t involve the children, it’s just the parent because there’s a specific topic to discuss, such as sleep or stress issues for their children.įor newborns, we’ve found some real value in video for lactation support for families. Q: How do the various ages of young people react to being on camera?ĭr. When they are here in the office, they’re usually wearing masks. It’s also nice to see our patients’ whole faces. It’s made most of us not fear video visits and actually look forward to them. We now are doing something called “virtual rooming,” where the support staff starts the remote visit with the patient to assure a smooth technological connection, and the doctor then joins. The video component adds a whole new level of complexity. We’ve done telephone visits for a long time and most people are comfortable speaking on the phone - we’re really good at telephone assessments. Gizzi: It’s been a learning experience for all parties. Q: How is the transition to video visits with children and families going overall? Elio Gizzi, MDĭr. Two of the editorial’s authors - Elio Gizzi, MD, a Richmond-based TPMG pediatrician, and Edward Lee, MD, a TPMG associate executive director and chief information officer of The Permanente Federation - discuss what this seismic shift in technology means for doctors and their young patients. The authors note benefits for families, including not having to cajole children into a trip to the doctor, find parking, and mingle with potentially ill children in the waiting room. Physicians and medical staff were trained to use the video care option. When Northern California’s shelter-in-place orders began in March 2020, TPMG’s physicians realized that the new normal for many doctor appointments, including pediatrics, would be virtual. “As a pediatrician, I feel very fortunate to be part of a medical group that’s been so proactive about helping our physicians and patients into this new era.” Lieu, also a practicing pediatrician with The Permanente Medical Group (TPMG). “Our rapid learning curve in providing video care has been really impressive,” says Dr. The trio, led by Kaiser Permanente Division of Research Director Tracy Lieu, MD, MPH, describe what they’ve learned in this transition for about 850,000 children who are Kaiser Permanente members in Northern California. Parents, children, and pediatricians with Kaiser Permanente Northern California (KPNC) have found advantages to home-based video medical visits, which have increased markedly since the beginning of the COVID-19 pandemic, write 3 physicians in a Nov. ![]() A transition accelerated by a pandemic could permanently shift more care delivery to ‘patients’ turf’
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