5991 Impact of virtual video clinic on neonatal neurodevelopmental assessments during COVID-19 pandemic and beyond

• Published in: Archives of disease in childhood Vol. 109; no. Suppl 1; pp. A291 - A292
• Main Authors: Khader Gaffari, Mohammed Abdul, Hirudhayaraj, Angel Mary, Chacko, Shoba Mary, Qubaisi, Mai Abdulla Al, Nimeri, Nuha Abdelghafar MA, Kannappillil, Shihab, Parappil, Hussain, Preez, Ilse Du, Khzzam, Fadi Abdulhay Al, Alkhdr, Mahmoud Oklah, Daloraya, Donnacel Overos, Suleiman Abu Jarir, Rawia Hasan, Alsayigh, Safaa, Abdelwahab, Abdellatif Hamdy, Tawfik Al Rifai, Hilal Amin
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01-08-2024; BMJ Publishing Group LTD
• Subjects: Clinics; Comparative analysis; COVID-19; Geographical distribution; Information technology; Neonates; Neurodevelopmental disorders; Newborn babies; Paediatric Clinical Leaders: Service Planning, Provision and Best Practice; Pandemics; Pediatrics; Questionnaires; Telemedicine; Video Technology
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2024-rcpch.457

ObjectivesThe COVID-19 pandemic made it difficult for patients to attend physical clinics (neonatal neurodevelopmental clinics). Telehealth has been used for virtual clinic before.1 The purpose of this study was to evaluate the effectiveness of implementing virtual video clinics as an intervention for assessing neurodevelopmental milestones in infants.MethodsA virtual video software was identified by the Information Technology team at Hamad medical corporation. Short training and user specific login details were generated. A detailed pathway established for the steps involved. Specialist nurse for the clinic educated the mother on how to download and login the software 1–2 days prior to the appointment time. During the lockdown stage of pandemic all assessments were done through the virtual clinic. Once the restrictions were lifted, full time face to face clinics were resumed. However, we continued to utilize the Virtual clinic. We developed specific referral criteria as detailed in figure 1. VC is used for 8th month (when the stranger anxiety develops) and at 18 months visit if they are considered to fall in the low-risk category in previous assessment. The Ages and Stages Questionnaire (ASQ) was utilized as the assessment tool.2 comparative analysis was conducted to determine the percentage of no-show rates and the ability to finish assessments in a timely manner.ResultsIn the pre-pandemic period of year 2017, the no-show rates were 25.5% (190/744), while in 2021 it reduced to 10.4% and reduced to 5.4% (52/955) in 2022. (p < 0.001). Furthermore, the virtual video clinics allowed for assessments of babies who had moved out of the country, ensuring comprehensive evaluation regardless of geographical location. Importantly, all assessments were successfully completed (100%) during the virtual clinic sessions. Virtual clinics offered consultations even when a parent is ill to come to the hospital. It allowed demonstration positioning, handling of these babies. We called people all over the world like Pakistan, Macedonia, Sudan, Nepal and India etc.ConclusionImplementation of virtual video clinics as an intervention for neurodevelopmental assessments during the COVID-19 pandemic has proven highly effective. The significant reduction in no-show rates indicates, increased accessibility and convenience for caregivers, facilitated timely evaluations. Moreover, the virtual clinics enabled comprehensive assessments for neonates who moved outside the country. These findings support the use of virtual video clinics as an alternative and efficient approach for neurodevelopmental assessments, ensuring continuity of care during times of restricted physical access. Further research is needed to investigate the long-term effectiveness and sustainability of virtual clinics beyond the pandemic.ReferencesLeyser M, Schieltz K, Strathearn L, Cooper-Brown L, McBrien D, O’Brien M. Telehealth in the field of developmental-behavioral pediatrics: advantages, challenges, and future perspectives. J Dev Behav Pediatr. 2021 Apr 1;42(3):240–244. doi: 10.1097/DBP.0000000000000920. PMID: 33759849.Kerstjens JM, Nijhuis A, Hulzebos CV, van Imhoff DE, van Wassenaer-Leemhuis AG, van Haastert IC, Lopriore E, Katgert T, Swarte RM, van Lingen RA, Mulder TL, Laarman CR, Steiner K, Dijk PH. The ages and stages questionnaire and neurodevelopmental impairment in two-year-old preterm-born children. PLoS One. 2015 Jul 20;10(7):e0133087. doi: 10.1371/journal.pone.0133087. PMID: 26193474.