Kim Ji Won, Lame Maria, Szalay Leanna, Lefchak Brian, Johnsson Bille, Gogia Kriti, Clark Sunday, Kessler David, Leyden David, Sharma Rahul, Platt Shari
Department of Emergency Medicine, NewYork-Presbyterian and Weill Cornell Medicine, New York, New York, USA.
Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Telemed J E Health. 2021 Oct;27(10):1105-1110. doi: 10.1089/tmj.2020.0413. Epub 2021 Jan 11.
Background:Our objective is to describe our pediatric virtual urgent care (VUC) experience at a large urban academic medical center, in response to the COVID-19 pandemic in New York City (NYC).
Materials and Methods:We conducted a retrospective cohort study of our pediatric VUC program of patients less than age 18 years, from March 1 to May 31, 2020. We include data on expansion of staffing, patient demographics, virtual care, and outcomes.
Results:We rapidly onboarded, educated, and trained pediatric telemedicine providers. We evaluated 406 pediatric patients with median age 4.4 years and 53.9% male. Median call time was 5:12 pm, median time to provider was 5.7 min, and median duration of call was 11.1 min. The most common reasons for a visit were COVID-19-related symptoms (36%), dermatologic (15%), and trauma (10%). Virtual care for patients consisted of conservative management (72%), medication prescription (18%), and referral to an urgent care or pediatric emergency department (PED) (10%). Of 16 patients referred and presented to our emergency department, 2 required intensive care for multisystem inflammatory syndrome in children. Oral antibiotics were prescribed for 7.1% of all patients. Only 0.005% of patients had an unplanned 72-h PED visit resulting in hospitalization after a VUC visit.
Conclusion:Pediatric emergency VUC allowed for high-quality efficient medical care for patients during the peak of the COVID-19 pandemic in NYC. Although most patients were managed conservatively in their home, telemedicine also enabled rapid identification of patients who required in-person emergency care.
我们的目标是描述在纽约市（NYC）应对新冠疫情期间，我们在一家大型城市学术医疗中心开展儿科虚拟紧急护理（VUC）的经验。
我们对2020年3月1日至5月31日年龄小于18岁的儿科VUC项目患者进行了一项回顾性队列研究。我们纳入了人员配备扩充、患者人口统计学特征、虚拟护理及结果的数据。
我们迅速招募、培训并教育了儿科远程医疗服务提供者。我们评估了406名儿科患者，中位年龄4.4岁，男性占53.9%。中位呼叫时间为下午5:12，中位等待医生时间为5.7分钟，中位通话时长为11.1分钟。就诊的最常见原因是新冠相关症状（36%）、皮肤病（15%）和外伤（10%）。对患者的虚拟护理包括保守治疗（72%）、开具药物处方（18%）以及转诊至紧急护理或儿科急诊科（PED）（10%）。在转诊至我们急诊科并就诊的16名患者中，2名因儿童多系统炎症综合征需要重症监护。所有患者中7.1%开具了口服抗生素。在VUC就诊后，只有0.005%的患者计划外72小时内到PED就诊并住院。
在NYC新冠疫情高峰期，儿科紧急VUC为患者提供了高质量的高效医疗服务。尽管大多数患者在家中接受保守治疗，但远程医疗也能够快速识别需要现场紧急护理的患者。
