Table 3.

Telehealth challenges, along with representative quotes by the caregivers.

		Study Population, N = 105
Video and telephone visits Lack of in-person interaction/preference for in-person visits ○ Participant: “Children are depersonalized when they’re in a video call…it’s like a 50% appointment.” ○ Participant: “In-person visits are better. You lose the relationship or sense of empathy when you’re not in the same room.” ○ Participant: “I believe face-to-face is the best care for well-visits.” ○ Participant: “I don’t think telehealth would have worked for a well visit.” ○ Participant: “I prefer face to face as long as the office follows safety precautions.” ○ Participant: “Given the issues my daughter has had, the in-person care has been more of what was necessary.” Technological problems ○ Participant: “We just couldn’t get it to work. It was frustrating to say the least.” ○ Participant: “Televisit technology needs to be more reliable. Our personal experience took several attempts to connect. My child had a fever and a head-to-toe rash, and the doctor could not see things because the app ran so poorly.” ○ Participant: “The endocrinologist for my son was a disaster as telehealth. The appointment had the worse connection. Worthless appointment.” ○ Participant: “Connection issues, trouble accessing records (keeps me from using it).” Fear of compromised confidentiality ○ Participant: “I guess the worry was if your information is still confidential.” ○ Participant: “Awareness and personal records security (keeps me from using telehealth).” Difficulty in understanding/receiving information. Easier/less stressful to process and understand information given in person ○ Participant: “The information is still there but I receive it better in person.” ○ Participant: “The stress from COVID-19, I do not want to continue researching and using electronic devices.” Potential misdiagnosis due to camera angle, lighting, etc. ○ Participant: “It could leave room for error or a misdiagnosis because something might look like something else (when) you’re not looking at it up close and personal.” Patient portal, email, appointment scheduling Problems with multiple portals or logins ○ Participant: “The different portals do not interface.” ○ Participant: “We should still be able to login to both charts as we are 2 separate individuals without continued access issues and blocking access frequently.” ○ Participant: “A user-friendly app would be great that’s easy to access without a million passwords to get into it.” Potential for misinterpreting email messages both by the physician and patient ○ Participant: “When you are typing things out, things can be misinterpreted.” Impersonal communication ○ Participant: “It didn’t feel very personable, because it is usually a text message or just like a standard written email.” Slow response time after sending an email to the physician ○ Participant: “If I call, they will help me at that moment versus if I use health technology, it probably would take a couple of days.” Online availability did not reflect all days/times available for scheduling appointments ○ Participant: “if we go online to try and schedule an appointment: there is less availability then if we were to actually call. Then there is a little more availability.”