Pediatrician Imagine Pediatrics HOUSTON, Texas, United States
Background: Children with medical complexity (CMC) experience the most intense healthcare needs and often require medical technology to improve or sustain life and daily function. Traditional fee-for-service models do not effectively allow for reimbursement of the numerous daily non-patient-facing tasks necessary to ensure high quality care for CMC. Novel value-based care arrangements are poised to improve access and fill gaps in care.
The American Academy of Pediatrics endorses telehealth as a “critical infrastructure.” Telehealth improves timely access to care, fosters avoidance of unnecessary healthcare utilization and allows for a visible assessment of in-home non-medical drivers of health.
Current undergraduate medical education does not effectively prepare medical students to perform telehealth evaluations nor understand novel alternative payment models. Objective: To introduce learners to a value-based model of care, delivered primarily via telehealth, for children and youth with special health care needs (CYSHCN) and CMC. Design/Methods: We are an elective community preceptor site for third-year medical students (M3s). We designed a four-hour medical student telehealth curriculum such that, by the end of this brief rotation, learners would be able to define and describe the CYSHCN and CMC populations, contrast the various drivers of patient visits in a fee-for-service model versus value-based model and recognize recommended strategies of utilizing telehealth for two common pediatric complaints (respiratory distress, dehydration). We used PowerPoint didactic slides, case-based discussions, and observation of telehealth visits. Students completed a pre-/post-rotation learner assessment and rotation evaluation using Likert scale type questions. We used a paired t-test to compare pre-/post- responses. Results: Our survey was completed by all 37 rotating M3s. Students demonstrated a statistically significant improvement in self-reported knowledge and confidence in 7 items (Figure 1). Additionally, students deemed our curriculum to be extremely effective (Figure 2).
Conclusion(s): We designed a brief medical student curriculum in value-based pediatric telehealth. Students expressed a significant improvement in knowledge of and confidence in conducting telehealth visits. Next steps include expanding our curriculum to include several common pediatric pathologies.
