The COVID-19 Pandemic and Rapid Implementation of Adolescent and Young Adult Telemedicine: Challenges and Opportunities for Innovation

This study describes the rapid implementation of telemedicine within an adolescent and young adult (AYA) medicine clinic in response to the Coronavirus Disease 2019 (COVID-19) pandemic. While there are no practice guidelines specific to AYA telemedicine, observations made during this implementation...

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Bibliographic Details
Published in:Journal of adolescent health Vol. 67; no. 2; pp. 164 - 171
Main Authors: Barney, Angela, Buckelew, Sara, Mesheriakova, Veronika, Raymond-Flesch, Marissa
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.08.2020
Elsevier BV
Society for Adolescent Health and Medicine
Subjects:
Addiction medicine
Addictions
Adolescent
Adolescent Health Services
Adolescent medicine
Adolescents
Adult
Best practice
Challenges
Child
Clinical practice guidelines
Confidentiality
Coronavirus Infections - epidemiology
COVID-19
Diffusion of Innovation
Disorders
Eating disorders
Feeding and eating disorders
Female
Health disparities
Humans
Implementation
Innovations
Male
Medical technology
Medicine
Mental health
Mental health care
Mental health services
Pandemics
Patients
Pneumonia, Viral - epidemiology
Problem solving
Quality of care
Reproductive health
Reproductive health services
Substance abuse treatment
Teenagers
Telecommunications
Telemedicine
Telemedicine - organization & administration
United States - epidemiology
Visits
Young Adult
Young adults
United States
Telemedicine
Feeding and eating disorders
Adolescent
Adolescent medicine
Adolescent health services
Reproductive health services
Addiction medicine
ISSN:1054-139X, 1879-1972, 1879-1972
Online Access:Get full text
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Summary:This study describes the rapid implementation of telemedicine within an adolescent and young adult (AYA) medicine clinic in response to the Coronavirus Disease 2019 (COVID-19) pandemic. While there are no practice guidelines specific to AYA telemedicine, observations made during this implementation can highlight challenges encountered and suggest solutions to some of these challenges. Over the course of several weeks in March, 2020, the Adolescent and Young Adult Medicine Clinic at the University of California San Francisco rapidly replaced most in-person visits with telemedicine visits. This required logistical problem-solving, collaboration of all clinic staff members, and continuous reassessment of clinical practices. This article describes observations made during these processes. Telemedicine visits increased from zero to 97% of patient encounters in one month. The number of visits per month was comparable with that one year prior. While there were limitations to the clinic’s ability to carry out health supervision visits, many general health, mental health, reproductive health, eating disorders, and addiction treatment services were implemented via telemedicine. Providers identified creative solutions for challenges that arose to managing general confidentiality issues as well as specific challenges related to mental health, reproductive health, eating disorders, and addiction care. Opportunities to implement and expand high-quality AYA telemedicine were also identified. The COVID-19 pandemic is leading to widespread telemedicine implementation. While telemedicine seems to be feasible and acceptable for our clinic patients, unanswered questions remain regarding confidentiality, quality of care, and health disparities. Clinical guidelines are also needed to guide best practices for telemedicine in this patient population.
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ISSN:1054-139X
1879-1972
1879-1972
DOI:10.1016/j.jadohealth.2020.05.006