Introduction to Online Pediatric Consults with Dr. Diana Delgado, MD., F.A.A.P, MS.

Parenthood is a particularly challenging period for many families. Often you are burdened with managing various ailments that may afflict your child. Access to quality pediatric specialists is a common issue even with adequate family insurance plans with virtual care. 

That is why many have chosen to do their own healthcare research online and have their child’s health be taken care of by a preferred provider who is appropriately qualified in treating childhood illnesses, and most importantly, has the unique amicable personality that can place an upset child at ease, even during a telemedicine consult.

In this publication, Dr. Diana Delagado, MD will briefly highlight for you the key insights of online child care and how parents can use virtual care to seek the right answers for their pediatric-related queries.

Why would you seek online consultation for your child’s health?

Virtual telemedicine allows people to take the opportunity to ask an experienced, Board-Certified pediatrician or a related healthcare specialist, to ask the questions you have about your child’s health but have not had the opportunity or been given the time to ask.

In most pediatric clinics, doctors are overburdened by cases and often we do not have time to take a full history of your child’s overall health and development nor is there often ample time to explain the treatment after we prescribe it. 

In telemedicine sometimes it is a bit easier to simply select your provider, make an online appointment and ‘appear’ for the virtual session where there is enough time for a full conversation where the pediatrician can explain in simple non-medical jargon, demonstrate any procedure (such as how to use a nebuliser for children) and even go through some medical reports without being hurried.

I can empathise that parents are so busy these days with so many issues, when your child becomes ill, especially if they have a complex chronic illness, an entire day has to be taken out of work just to find a pediatrician you can trust and afford with your co-pay or deductible. 

This is why the convenience of at home care and at home online consults can be an immense opportunity for holistic care for the family.

However, even during this era of virtual medicine, it is still challenging to connect with a child specialist online who does provide telemedicine visits and is covered by your medical insurance. I can tell you countless instances of parents who spend hours online looking for online consults with a pediatrician near their home, but end up not being able access that healthcare due to insurance regulations or that practice does not accept new patients virtually, that is the first visit has to be in-person and then maybe a follow up can take place online.

There really needs to be an easier way for parents to seek pediatricians and other specialists online. Someone they can trust from their credibility, compassion and coverage.

Nonetheless I am positive that the people have spoken. State legislature may change depending on market demands, lobbying and even patient support groups who may allow for multiple state access. I am also aware of many international options that many people have tried recently with great success. 

What kind of Healthcare Services can I get with a Pediatrician Online?

Telemedicine visits are a convenient way to get answers to your specific health questions in a one-on-one consult session in which the Doctor answers your questions, addressing your specific concerns.

Using virtual care, you can avail many specific services such as:

1. Provide a quality-based option for parents to ask questions about a chronic, previously treated, specific health concern relating to their child
2. An option to get more information about general pediatric concerns that children commonly face as they are growing up
3. Offer an opportunity to talk about common aspects of routine pediatric care in general pediatrics
4. Obtain evidence- based, practical information from an experienced, Board-Certified professional in the Pediatric field about pediatric health topics of your interest, which are evidence based.
5. Obtain information about specific childhood Infectious diseases, Infection Control procedures from a scientific source which you may use at home.

The focus of a consult is a quality-based, individualised , ‘no-rush’ interaction in which you can ask your specific questions based on your specific needs, and be structured in a way that you can understand, even in your own language. A well informed caregiver is the best person who can provide safe at home management for your child.

For this reason, we are ”not looking at the clock”. all consults, no matter the topic, have a pre scheduled time limit of your choosing, with options starting at 30 minutes, in which is entirely up to you what questions to ask and what to talk about.

Most clinic visits are hardly 15min and most of the time the doctor is busy typing away nodes and charts at his desk, but in telemedicine we have the opportunity for uninterrupted eye contact and to display our non-verbal communication cues. These are all part of the ‘webside’ manners that can cultivate a positive patient experience.

What can I Discuss with a Pediatrician Online?

There are several pediatric conditions/topics that can be discussed in pediatric consults such as:

• Allergies
• Obesity
• Speech concerns
• Growth and development concerns. Please have an up- to- date weight and height for your child.
• Feeding and Nutrition questions. Please have an up -to- date weight and height for your child.
• Questions about Infectious diseases
• Breastfeeding
• Childhood Vaccines
• Mild acne
• Eczema
• Questions relating to long term asthma management, causes of disease, and its triggers in stable patients
• Behavior concerns

The doctor can explain the rationale for a procedure and discuss laboratory test results, with your permission of course. There might be an option to share a photo image or a download link where the provider can view the report or image (this is quite useful in dermatological cases). If not the patient can just position the report in front of the camera for a quick view, but often the best thing to do is to simply read out the radiographer’s conclusion at the bottom of the medical report.

The online provider can also answer questions you may have about the causes of a specific disease, disease management, possible treatments of a condition you are interested in as it relates to your child. Maybe you have questions about Infectious diseases and/ how to prevent certain infections like diaper rashes, impetigo, flu or even food poisoning.

Are there any Key Points to Consider Before Looking for a Pediatrician Online?

Most types of Telemedicine or Digital Health in general is not designed to help in acute emergencies or life-threatening cases. It is important that parents call for emergency help in their locality or with a National Emergency Helpline in such scenarios.

If your child is very sick or acutely ill  eg. has a loss of consciousness, suffered a severe trauma, high grade fever, cough, sore throat , expanding rash, pain symptoms , is having an asthma flareup, seizure, he/she will need a different evaluation that cannot be  provided on a digital health platform. Please contact your child’s primary care provider or emergency hotline according to your discretion.

Most online healthcare platforms do not provide digital online prescriptions (especially for controlled substances). If your child needs a prescription or a refill, please contact your child’s primary care provider.

Telehealth Consults are NOT intended to be a replacement for the recommended well child care and routine physical examinations/immunizations .It is still recommended that children follow the routine childhood schedule for well exam care.

Online Consults are NOT intended to be a replacement for pediatric subspecialist care such as pediatric neurologist, pediatric cardiologist, pediatric endocrinologist etc.

What is your Prediction for Telemedicine in 2021?

I strongly believe that an amazing societal and health sector industry change is upon us all. It is the responsibility of diverse stakeholders to really assess how we as a society can use digital health technology, not just as a ‘pandemic tool’ but rather a way to cultivate a quality-centered and value-based solution for vulnerable members of society, especially for children who may have faced the worst burdens since the global lockdown.

I think in the remainder of this year, many healthcare professionals will seriously consider telemedicine as a viable career choice, as an adjunct to their regular physical practice. And patients will now expect that their clinician is available offline and online, at their choosing.

Dr. Diana M Delgado, MD, F.A.AP., MS

About VIOS

At VIOS we seek to provide highly personalised consults with childhood developmental experts and dedicated pediatricians, to help you make an honest and informed decision to best care practices.

Free from bias or judgement, our professionals are dedicated to respecting the patients’ choice in selecting the right practitioner, who can easily describe the issues at hand, in a convenient virtual care setting.