Healthy Kids - Summer 2021

New Frontiers and Possibilities

Dr. Griffin explains that the past year has presented a learning curve for practically everyone at Rady Children’s, as they’ve had to adjust to telehealth appointments on the fly. “This is a new frontier,” he says. “We’re all trained to keep our hands on people, and to figure things out with a physical exam.” He reiterates that, more often than not, an in-person visit is still preferable, especially for evaluating the nuanced distinctions of symptoms such as abdominal pain or respiratory distress. And when it comes to writing prescriptions—even for medications as common as antibiotics—the physician will still want to examine a patient hands-on. For occasions when a telemedicine appointment reveals issues that can’t be diagnosed remotely, he and his colleagues at Rady Children’s work quickly to schedule an in-person visit for the patient, usually the same day. “But,” he adds, “it certainly does have its place for those other problems that don’t necessarily need a head-to-toe physical exam.” In addition to monitoring behavioral health, Dr. Griffin has learned that a variety of common skin problems, such as rashes, may be examined remotely, allowing a parent to address minor issues without leaving home. In some cases, a recurring issue requiring a prescription modification or renewal can be more quickly and easily accomplished with a video call than an office visit. “We’ve learned a lot over the past year with this, just seeing how it works,” Dr. Griffin says, “because before, nobody really knew how it would work in practice.” As the COVID-19 vaccination numbers rise, he’s finding more patients willing to schedule in-person appointments, but based on his experience over the past year, he anticipates a greater embrace of telemedicine in the months and years to come. “The technology is going to improve,” he says, “and our use of it, and how we deploy it.” The experience has also encouraged Rady Children’s to keep telemedicine options available moving forward—and potentially, to make some exciting investments to improve upon it. The rapid expansion of telehealth protocols last year was made possible by a collaborative effort between Hospital physicians, administration and information technology staff seeking to create a standard of best practices. Administration and physician leaders have been closely monitoring patient access to care—and reviewing patient and family satisfaction—to make informed decisions about future telemedicine applications. One possible outcome involves finding ways to provide patients with web-connected medical devices, so their doctors can collect vital signs remotely. Rady Children’s currently has an audiology program that supplies patient families with digital otoscopes, which allow their doctor to look into the ear canal remotely. With the advent of each new smart medical device, more and more of these standard examinations will be available and reliable for in-home appointments. Rady Children’s is actively looking to provide technology for use in patient homes, such as digital stethoscopes to monitor the heart, digital spirometers to measure lung capacity and integrated pulse oximeters to check blood oxygen levels (both of which are crucial measurements for monitoring COVID-19 infection). The pandemic may have pushed the medical community into telemedicine out of necessity, but in doing so, it’s given us a glimpse of how this technology can be used to make our health care systemmore efficient, more effective and more user-friendly, especially for the vulnerable children and families Rady Children’s cares for every year.

THE LOPEZ FAM I LY is thriving, thanks to technology that wouldn’t have been possible a few years ago

In the meantime, patient access to telemedicine is increasing as the technology improves—and we’re not just talking video quality. There’s also tech that increases patient access to health care providers and to their own medical records. When Megan describes how positive her experience with Rady Children’s has been, she gives some credit to the MyChart app, where she’s able to view all of Gracie’s test results, appointments and prescriptions in one place, whether they originated from Rady Children’s or from Gracie’s birth hospital. Just as importantly, she’s able to connect to the long list of providers contributing to Gracie’s health care, and they’re able to view her ongoing treatments and appointments across specialties. For instance, when Gracie’s gastroenterologist was ordering lab work and ultrasounds, she noticed the child also had an upcoming appointment with a hepatologist. So the doctor reached out to her colleague to ask if they wanted to add any blood work to the order, in anticipation of their appointment later on. Megan says the app has also given the family direct access to Gracie’s primary physician, Steven Griffin, MD, whom they see at the Murrieta clinic as well as remotely. “I’ll message him, and he always gets back to me the same day,” she says. “Sometimes it’s eight o’clock at night and he’s emailing me back through the app.” Dr. Griffin explains that, while young parents have always tended to reach out to their pediatricians often, advances in technology have made it easier. “Over the past 10 years or so, as we’ve gotten more electronic, we have a lot of messages from patients,” he says. “A new parent will be very nervous, and they’ll send us 20 different messages.” However, he notes that he’s found using telehealth visits to address such concerns to be far more effective. “It’s very much appropriate for having a longer discussion, instead of going back and forth with messages.”


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