A comprehensive multi-institutional study reveals that telemedicine has become a lasting component of paediatric primary care, with targeted use in behavioural health and endocrine visits, and potential to boost overall healthcare access and volume.
Telemedicine has become a durable part of paediatric primary care rather than a pandemic-era stopgap, according to a multi-institutional study led by researchers at Children’s Hospital of Philadelphia. Published in Pediatrics, the research found that virtual appointments are now used most often for problem-based visits involving children with endocrine and behavioural health needs, where ongoing follow-up is especially important and physical examinations are not always required at every consultation.
The analysis drew on electronic health records from 1,088 practices and covered 19,633,472 problem-based visits for patients under 18 between 2019 and 2024. Researchers found that telemedicine accounted for less than 1% of such visits in 2019, surged to 55% in April 2020, and then fell back to 6% by 2024 as in-person care resumed. By the end of the period studied, the six areas with the highest share of virtual problem visits were behavioural health, endocrine care, dermatology, infectious disease, digestive health and respiratory conditions.
Alexander Fiks, the study’s lead author and director of Clinical Futures and the Possibilities Project at CHOP, said the sharp rise in use in 2020 was driven by necessity, but added that the field now has a chance to understand where telemedicine delivers the greatest value. CHOP’s wider digital health work, which includes video visits, remote patient management and virtual urgent care, reflects the hospital’s broader investment in using technology to make paediatric care more accessible and convenient for families.
The findings also suggest that telemedicine may do more than simply replace in-person appointments. From 2019 to May 2023, each additional virtual visit was linked to no meaningful change in total visit volume. After May 2023, however, each extra telemedicine appointment was associated with higher overall visit numbers, hinting that some practices may now be able to see more children because virtual care is being used more routinely. That said, the authors stressed that major barriers remain, including patchy internet access, lack of devices in some homes, workflow challenges and some clinicians’ preference for office-based care. Previous CHOP work in rare genetic conditions has also pointed to inequities in telemedicine uptake among families from historically marginalised backgrounds, underlining that access is not yet equal.
Fiks said further research is needed to determine whether the rise in virtual problem visits improves health outcomes as well as convenience. The study was supported by a National Institutes of Health grant, with additional infrastructure funding from the American Academy of Paediatrics and the Health Resources and Services Administration.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
