The financial implications of telemedicine practice patterns across pediatric surgical specialties.

Background: Telemedicine has played an increasingly important role in surgical care during the coronavirus disease 2019 (COVID-19) pandemic, yet little is known about its usage and correlation to cost both within and across surgical specialties during the pandemic.

Study Design: We collected data on telehealth encounters from April 2020 to June 2021 for all surgical specialties at a pediatric academic institution. The percent of total encounters that were telemedicine vs. in-person were analyzed over time. Data on charge and reimbursement were averaged for each encounter type, and the percent difference in average charge and reimbursement was calculated and compared between surgical specialties.

Results: Of the 147,007 surgical clinical visits identified, 6,566 encounters (4.5%) were telemedicine. Usage peaked in April and plateaued in June of 2020. The specialties with the highest total percentages of telemedicine visits were neurosurgery (23.2%) and cardiovascular-thoracic (11.9%). Orthopedics reported the lowest usage at 2%. Charges for in-person encounters were higher for nearly all specialties while reimbursements remained equal.

Conclusion: Our institutional trends reveal that conversion to telemedicine varied across surgical specialty during the COVID-19 pandemic. Charges for in-person encounters were higher than telehealth ones for nearly all specialties, but the reimbursements were fairly the same. Understanding trends in telemedicine volume instigated by and following the pandemic may better prepare pediatric institutions to navigate the accelerated adoption and influence policy changes. This is particularly relevant given the fluctuating impact of the pandemic on healthcare institutions as new strains of COVID-19 emerge.

Evidence Level: Level V.