Impact of Social Determinants and Digital Literacy on Telehealth Acceptance for Pediatric Cardiology Care Delivery during the Early Phase of the COVID-19 Pandemic.

Baker-Smith, Carissa M; Sood, Erica; Prospero, Carol; Zadokar, Varsha; Srivastava, Shubhika

OBJECTIVE(S) To determine if telehealth acceptance by parents of children with heart disease is predicted by sociodemographic and/or by parental digital literacy; and to assess parental perceptions of TH usability and reliability. STUDY DESIGN We conducted a single center study comparing TH acceptance versus visit cancellation/rescheduling for pediatric cardiology visits during the early phase of the COVID19 pandemic. All parent/guardians who consented to survey completion received a validated survey assessing their DL. Consenting parents who accepted TH received an additional validated survey assessing their perceptions of TH usability and reliability. RESULTS 849 patients originally were scheduled for in-person visits between March 30 and May 8, 2020. TH acceptance was highest among younger, publically insured, Hispanic patients with primary diagnoses of arrhythmia/palpitations, chest pain, dysautonomia, dyslipidemia and acquired heart disease. Among parents who completed surveys, a determinant of TH acceptance was DL. TH was determined to be a usable and reliable means for health care delivery. CONCLUSION Although the potential for inequitable selection of TH due to sociodemographic factors exists, we found that such factors were not a major determinant for pediatric cardiology care within a large, diverse, free-standing pediatric hospital.