Pediatric Telehealth: The Doctor Is ON(line)
Bridging the Pediatric Gap in New Mexico with Virtual Doctor Visits
By Jenny Achilles
We have nearly come full circle from the time when doctors would make home visits to see patients. Now doctors are making home visits again, but this time virtually.
There’s a new way to see a pediatric doctor in New Mexico. Kids can now be seen by a pediatrician from their homes and schools instead of driving to a clinic. A child can say “Ahhh” in front of their parent’s smartphone while a pediatrician peers at the image to make a diagnosis. Through a secure electronic connection, pediatricians can see patients, order labs and x-rays, and prescribe medications. Telehealth is a big win for kids, parents, and the doctors who want to reach families who have less access to comprehensive, high-quality pediatric care. It can also decrease unnecessary late-night trips to emergency rooms. Families don’t have to leave their homes, kids can return to class or play, and parents can stay at work.
Local pediatric providers Dr. Jennifer Achilles, MD, and Misha Harris, CPNP, created Telepeds, New Mexico’s first woman-owned pediatric telemedicine company. Telepeds uses the convenience of telemedicine to bring the doctor to kids and families within their homes. This can be done simply with a smartphone, tablet, or laptop. After working many years in New Mexico, it became clear to the cofounders that the current system of healthcare for kids and families wasn’t working for all families. Many families face challenges when trying to schedule an appointment for their kids — whether it’s distance, cost, time, availability, or convenience. Another motivation in creating Telepeds was the knowledge that New Mexico regularly ranks last in the country for overall child well being. One reason for this is lack of access to healthcare, which results in worse health outcomes. In response to these significant problems, Achilles and Harris created a telehealth company that prioritizes equity. Their mission is to improve the health of all children in New Mexico by increasing access to pediatric providers.
It was an auspicious time to begin a telemedicine company, as demand for telemedicine increased dramatically during the height of the pandemic. Families were able to access pediatric care without having to leave their homes and kept kids safe by minimizing exposure to the virus. Now that patients have experienced the convenience of telemedicine, demand is likely to continue to grow.
There is a strong correlation between access to medical care and improved health outcomes for our community. Telehealth is one piece of the puzzle to improve access to care, particularly for vulnerable children. This also helps reduce emergency room visits for non-emergent conditions, reduces absenteeism, and keeps parents at work. On-demand access to virtual urgent-care visits from home and from schools is a critical step forward to ensure health equity throughout every neighborhood.
Telepeds has already helped many families in New Mexico
The day Emma brought her new baby home from the hospital, her 2-year-old daughter came down with RSV, a common viral respiratory infection in kids. Instead of having to pack everyone up again and bring them to the clinic, she was able to make an appointment from her phone and be seen immediately. She was immensely grateful to be able to get her daughter the care she needed and to not have to leave her house or her newborn.
Madeline is a mom of two kids, and when her 2-month-old daughter developed a strange rash, she immediately tried to make an appointment for her. Unfortunately, her doctor’s office did not have any available appointments for at least a week. She was then able to schedule an appointment online and her daughter was seen within minutes. She was so happy she didn’t have to wait a week or go to the ER. She was able to get a diagnosis and have all her questions answered.
Telepeds providers have also seen multiple visits for COVID, answering questions, providing guidance, and helping families make the decision of whether an ER visit is needed. Each appointment ends with education for families that includes signs to look out for and when to schedule another visit if needed.
Children often suffer from respiratory illnesses. Through taking a detailed history and a visual exam, online providers differentiate between viral illnesses (i.e., COVID, flu, colds), asthma, and pneumonia. They can order labs and x-rays when needed to help clarify a diagnosis. Once the diagnosis is made, online doctors can then prescribe medications directly to a family’s local pharmacy.
Benefits and shortfalls of telemedicine
Telepeds helps connect families that are farthest away from pediatric care. Some rural families must travel hours to see a pediatrician, but they can now be seen from home or school. Kids don’t have to miss school, and parents don’t have to miss work. They also save time and money by not having to travel long distances.
There are many schools in New Mexico that do not provide access to school-based health centers. Several states are now using telemedicine to connect students to online doctors. This way students can be seen by a doctor immediately without having to leave school. Most children return to class after the visit, which improves learning and decreases absenteeism. Parents can join the visits virtually and can stay at work. Telepeds collaborates with schools to create school-based telehealth clinics.
Another benefit of telemedicine is convenience, such as the ability to securely text a doctor between visits with any questions. Also, providers can easily refer patients to specialists when needed. Prescriptions, labs, and x-rays are ordered from providers in the family’s community. Telepeds takes all insurance including Medicaid and has multiple self-pay options, so no families are excluded.
Many visits work well for pediatric telemedicine, such as asthma, allergies, colds and flu, COVID, vomiting, diarrhea, rashes, fever, earache, headache, sore throat, pink eye, urinary tract infection, breastfeeding difficulties, and newborn general questions and concerns.
Some visits are not appropriate for telemedicine, including seizures, altered mental status, severe infections, dehydration requiring IV fluids, severe respiratory distress, choking, and racing heart rate. This list is not all inclusive. If parents are unsure about whether to go to the ER, a quick telemedicine visit can help direct families to the right care at the right time.
Although telemedicine is increasing equity in healthcare, it is not the only answer. Unfortunately, some patients most needing access to healthcare are the least likely to have broadband internet. Broadband access in New Mexico is improving but not equal across all counties. However, visits can be completed on cell phones with strong signals. Obviously, telemedicine providers cannot do well child exams nor give immunizations — this will require high-tech futuristic engineering.
With all the benefits that companies like Telepeds can offer, New Mexico families are likely to increasingly use these services. It’s an exciting future for pediatric providers in New Mexico who are creating new models to equalize access to healthcare. With this technology available we see a bright future for New Mexico kids and students.
Jenny Achilles is a pediatrician who has lived in New Mexico for over 10 years. Outside of the hospital, she can be found camping with her husband and daughter. She is also an avid horseback rider. She and her family live in Santa Fe.
Misha Harris is a pediatric nurse practitioner who has lived in New Mexico for 15 years. Hiking, camping, traveling, and swimming are only a few of the many activities Misha does with her 4- and 9-year-old boys. They live together in a house they are remodeling in Albuquerque.