CHOP’s Division of Orthopaedics Makes Rapid and Successful Transition to Telemedicine Amid COVID-19 Pandemic

Stay-at-home orders have helped protect many children and their families from contracting or spreading COVID-19. However, while people take steps to keep the virus in check, the reality is that children across the greater Philadelphia region are still being injured or recovering from injuries sustained prior to the pandemic.

In a new report published in The Journal of the Pediatric Orthopaedic Society of North America, the Division of Orthopaedics at Children’s Hospital of Philadelphia (CHOP) details how they were able to transition to telemedicine in short order. Not only have telemedicine visits increased, but the clinical team and patient families have reported a high degree of satisfaction with these visits.

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Prior to the pandemic, telemedicine visits were possible and available to CHOP patients who visited with the Division of Orthopaedics, but they were limited to follow-up visits within a 90-day window after care was delivered. Once waivers by the federal government expanded who could receive telemedicine, the surgeons, sports medicine specialists and other members of CHOP’s orthopaedics team worked with CHOP’s digital health services to create a new system to see as many patients as possible using telemedicine.

Between March 15 and April 10, out of 1,692 visits completed in the Division of Orthopaedics, 543 were video visits, and 10 were telephone visits. Of those completed visits, 325 were

billed as established patients, 130 were postoperative or post-fracture, 70 were new patients, three were consultations, and five were telephone visits.

Virtual care for knee injuries, fractures, scoliosis

Lawrence Wells, MD More than one out of every five visits was for knee injuries, while fractures represented the largest number of post-operative telemedicine visits. Scoliosis accounted for the highest percentage of new patients. On a scale of 1 to 10, with 10 being very likely to recommend the use of telemedicine, the average score was 8.4 among 218 completed surveys. Nearly half of all those who took the survey said they did not experience any issues. The most common issues were that the video or audio stopped working or did not work at some point during the visit.

“Our findings demonstrate that our team is able to provide the same level of outstanding care while not forcing patient families to travel during these uncertain times,” said Lawrence Wells, MD, the Associate Director of the Sports Medicine and Performance Center at CHOP and senior author of the paper. “Across CHOP, we want to ensure that we are reducing potential exposure to the virus not only among our patients and their families but also our essential health care workers. Injuries are inevitable, so we want to reassure people that if you are injured, our team is here for you.”

The study was done with the assistance and cooperation of the Division of Orthopaedics at CHOP. The authors would like to offer special thanks for thought leadership and support from Linda Pellegrino, Orthopaedic Division Manager, nurse practitioner Kathy Abel, DNP, Quality, Safety and Value Advisory Lia McNeely, CPNP, and Jake Reilly from Clinical Informatics.

Leska et al. “How We Continued to Care for Our Patients: The Rapid Implementation of Telemedicine to Provide Pediatric Musculoskeletal Care in Response to COVID-19 at a Large Academic Children’s Hospital.” JPOSNA. Online 7 May 2020.