Philosophy of Telemedicine During Pandemic

Heritage Pediatrics Philosophy of Pandemic Telemedicine

On Monday, March 23, we will go to predominantly telemedicine for both well and sick visits. We understand that every contact we make must balance the risk of COVID spread with the benefit of a physical exam. Your pediatricians at Heritage wrestled with this decision. However, we agreed that this is the right time to reduce the exposure of our patients to a rising tide of asymptomatic carriers. We think it is in the best health interests of our staff and our patients even though we will likely not be reimbursed for much of the care at the beginning of this transition to telemedicine. Financial questions may be found here.

Vaccinations

We also agree with the American Academy of Pediatrics that vaccinations must continue to occur to protect our population as we rise from this pandemic. There are two primary reasons for this. First off, rates of vaccinations during this time are dropping with lack of access, which creates an increased chance of outbreaks in the near future. Secondly, there are many vaccine preventable illnesses that occur without human contact. These illnesses will continue despite social distancing.

Therefore, if we determine your child is due for vaccines after the well check, we will bring you to our parking lot to receive them from one of our nurses. If you are unable to come get your vaccine(s) after your telemedicine visit, we can schedule these shot visits for a later date. We will ask you to at least schedule these in our computer system so we can track the gaps in patient vaccine records.

Sick Telemedicine Visits

We do not believe that telemedicine is an ideal method to care for the sick child. However, we do believe we can do it well and still keep your child well cared for. Be prepared that your pediatrician will likely have to make difficult judgment calls without a full exam. This means we are going to have to use some judgment on whether your child has an ear infection, a sinus infection or a urinary infection, etc. Realistically, we are going to have to use antibiotics sometimes when we don’t need to. However, we think in these times, it’s safer to use certain medicines rather than to expose our patients to the risk of COVID-19 exposure. If you feel like we need to examine your child for some lump or bumps or belly pain, please discuss with our staff and we will decide on how urgent the exam must be. Generally we require a screening telemedicine exam before we will bring you in for a car visit.

Sick Car Visits

For those cases which we feel are too complex or cannot be completed without a physical exam, we will bring you into our covered car bays for a car exam. This may include breathing concerns, oxygen checks, and severe abdominal pain. This will be an important way to protect our emergency rooms from unnecessary visits and we need to utilize these judiciously.

Behavioral & Mental Health Consults and Follow-Ups (ADHD, mood)

We understand that these times are going to result in anxiety and depression for your children (and us parents). Telemedicine is an excellent way to address these matters. The wait time for these visits will be longer than most other visits we have. We will try to accommodate these real needs or get you in touch with local counselors to discuss these important matters.

These are extraordinary times. Heritage desires to continue to provide the same quality health care using the best and safest methods that we have at our disposal. If you have any questions about your health care needs physical or emotional, please reach out to our office. We will still be maintaining the same business hours and there will continue to be doctors on call at night and weekends.

We remain encouraged that most (>90%) infants and children will not get severely ill if they contract COVID-19. If they do, the vast majority will recover uneventfully. However, we want to keep parents healthy as well. Most parents will also recover from mild illness, but we need you to take care of your children right now. Most importantly, we don’t want your children or you to get sick and give to the more vulnerable or elderly in our families and community. Ultimately, this is why we made the decision to move to telemedicine thereby reducing physical contact whenever possible.