Table II.

Suggestions for optimizing telemedicine for pediatric patients in underserved populations

1. Triage new patients based on chief complaint • Certain conditions are more amenable to telemedicine (eg, acne, eczema, psoriasis) • Straightforward diagnoses and medication management can be scheduled as telemedicine • More complicated disease management and difficult diagnoses should be preferentially scheduled in-person • Requesting patients to send photographs prior to visit can assist with triage • Conditions in need of procedures should be scheduled in-person • Triage e-consults for in person or telemedicine based on the referring diagnosis

2. Assess patient desire for virtual care • Determine patient comfort with technology and if they own an appropriate device • Patients may have a preference for telemedicine versus in-person visit • Patients may have difficulty physically traveling to clinic and prefer a remote visit

3. Assess for barriers to telemedicine • Cultural beliefs may influence a preference for one visit type over another • Underserved, minority, and immigrant communities have lower rates of email use and patient portal activation. Applications and services with simple registration requirements helps to ameliorate this issue. • Determine the need for translator services • Implement a reminder system via calls or text messages to prepare patients for appointments

4. Schedule follow-up visits as in-person or telemedicine based on condition, treatment needs, and patient preference • Ensure choices are provided to patients and encourage selection of the option that most benefits them