Use of Telemedicine in Pediatric Orthopaedics Prior to the Pandemic: A Survey of POSNA Members

Background: Telemedicine, or telehealth, is broadly defined as the use of technology to deliver health care or health education at distance. Synchronous communication telemedicine, which involves the use of real time audio and video between patient and provider, is a developing field and its use in the pediatric orthopaedic population is not well defined. To better understand the existing use of and challenges posed by telemedicine for pediatric orthopaedic providers, the Pediatric Orthopaedic Society of North America (POSNA) practice management committee conducted a survey of current POSNA members. Methods: A 33-question survey was created by the POSNA Practice Management Committee, piloted among committee members and approved by the POSNA Evidence Based Practice Committee. A total of 167 responses were complete (75% complete response rate). Telemedicine use questions referred to the use of synchronous communication telemedicine. Results: A total of 50% reported being "moderately" or "not really" familiar with telemedicine. Sixty percent of study participants reported their hospital systems utilize telemedicine; however, only 40% reported utilizing telemedicine in their own practice. Sixty-seven percent indicated interest in telemedicine training. Telemedicine was utilized for a variety of patient pathology and visit types 57% of study participants did not bill for telemedicine services. Sixty-three percent were unaware of their states' billing rules regarding telemedicine. Conclusion: The survey is an attempt to understand the current landscape of telemedicine use within pediatric orthopaedics. Currently, a minority of survey participants utilize synchronous communication telemedicine. There is a desire for telemedicine training and best billing practices education. Further study to evaluate the limitations and efficacy of telemedicine in the pediatric orthopaedic population will be necessary as its use increases.