The COVID-19 pandemic has changed the way many of us are delivering care to our pediatric population. In an effort to keep patients, families and caregivers safe from possible exposure to the virus, St. Louis Children's Hospital is now offering virtual ED visits for pediatric patients who are experiencing respiratory symptoms.
Dr. Lozovatsky joins the show to talk about this new service and how your patients can access the service.
Virtual Pediatric Respiratory ED Visits
Featured Speaker:
Learn more about Margaret Lozovatsky, MD
Margaret Lozovatsky, MD
Dr. Lozovatsky is an Associate Professor of Pediatric Hospitalist Medicine at Washington University School of Medicine and the Chief Medical Information Officer for St. Louis Children's Hospital.Learn more about Margaret Lozovatsky, MD
Transcription:
Virtual Pediatric Respiratory ED Visits
Melanie Cole (Host): This is the St. Louis Children’s Hospital Podcast on COVID-19 dated April 27, 2020.
The COVID-19 pandemic has changed the way many of us are delivering care to our pediatric population. In an effort to keep patients, families and caregivers safe from possible exposure to the virus, St. Louis Children’s Hospital is now offering virtual emergency department visits for pediatric patients who are experiencing respiratory symptoms. This is Radio Rounds with St. Louis Children’s Hospital. I’m Melanie Cole and today, we’re discussing virtual pediatric respiratory ED visits during COVID-19 and how your patients can access this service. Joining me is Dr. Margaret Lozovatsky. She’s the Chief Medical Information Officer at St. Louis Children’s Hospital and she’s an Associate Professor of Hospitalist Medicine at Washington University School of Medicine. Dr. Lozovatsky, I’m so glad to have you with us and what an important topic. Tell us a little bit about this new service and how it came about.
Margaret Lozovatsky, MD (Guest): I am very enthusiastic about telling you how we developed this new service and how we think that it can be incredibly helpful for our patients. We realized as the COVID pandemic became a big crisis in our community, that all of our patients will be impacted. The pediatric patients are impacted at a lower rate than the adult population however, as we know, many pediatric patients experience respiratory symptoms especially during the flu and cold season that we were experiencing at the beginning of this. And so we wanted to provide an opportunity for all of those patients who may be symptomatic to receive their care at home in a safe environment.
Host: You mentioned that it’s a little bit more rare to see it in the pediatric population, but you are seeing flu and various other respiratory rotavirus, there’s all kinds of things going around with kids. So, tell us about the prevalence of COVID-19 in the pediatric population. What have you seen?
Dr. Lozovatsky: We sometimes don’t know for sure is the exact prevalence in the pediatric population because what we’re finding is that many kids have symptoms that are consistent with the presentation of COVID-19, however, because some of the symptoms may be more mild, those kids are not always tested. And so, even though we are seeing positive tests in the pediatric population, we know that there is a possibility that many more are impacted. We also know that kids don’t come to the hospital by themselves. They have their families to bring them and so those family members may also be affected by the COVID-19 pandemic and we know that keeping the whole family at home will decrease their exposure.
Host: Well we certainly have now reframed who we thought was at risk at this point. So, who should be using these virtual ED visits? Tell us a little bit about the procedure and how they get referred and really what happens.
Dr. Lozovatsky: We wanted to make the service available to as many patients as possible. So, we know that our pediatric offices are seeing their patients sometimes in the office and sometimes virtually. And in order to decrease exposures in those offices, and also to decrease exposures in our emergency department, we wanted to make sure that patients who are safe to be looked at via video who are stable enough and in a condition that does not require an emergency department visit, would have an opportunity to be seen by a physician, assessed via video to determine next steps.
Host: So, then how can a patient access this service, and do you have to be an existing patient to use the service? Tell other providers and pediatricians when their families call them and say I think we need to go to the ER, tell them how this works and what’s the next step.
Dr. Lozovatsky: There are several ways to get to My Chart where this is available. And I will talk you through the different ways that our patients can access the service. As a first step, I’d like to explain what My Chart is. So, that is our patient portal. Anybody can have an account in My Chart. They can access to be able to then log in, look at their child’s chart and in their child’s My Chart account, there is a symptom checker. They can go through the symptom checker to make sure that they qualify for these visits and that essentially means that they are safe enough to not need to bring their child in to be seen in person at that moment. And they can at that time, request an ED video visit and a physician will at that point, right away, be able to see them. And that physician can also order the test for them if needed.
And so to back up about how do you get to My Chart if you don’t already have it. We have spent a lot of time during this pandemic making sure that we have a way for as many patients as possible to be able to access this service. We now have a pathway for pediatric patients from Missouri to be able to create a My Chart account if they don’t have one. So, if they are not a patient of ours, there is a My Chart help desk number that they can call, and someone will talk them through making this account.
In the adult population of course, one makes an account for themselves. For kids, this is a little bit more complicated. And so the My Chart help desk has been trained to work with families that have kids of different ages and address their needs based on the age of the child. Anyone under the age of 11, will have a parental account so they are able to make an account for the parent if the parent doesn’t have one. And then the parent will request to have proxy access to their child’s account meaning that child account will be attached to theirs. And that can all be done with one phone call.
And then in our adolescent population, they can actually have their own account and so the team will speak with the adolescent, request their email and be able to send them an activation link to their email again in real time so that account can be created right away and these ED video visits can be accessed immediately.
Host: So, then who is providing care to the patient? Is it one of the ED docs? Who is doing that?
Dr. Lozovatsky: So, these services are provided by emergency room physicians, hospitalist physicians, and other pediatric subspecialists. We have a schedule where the majority of the time it’s an emergency room physician or another physician that has pediatric training that practices in our emergency department.
Host: Well that’s very reassuring for patients but for their pediatricians as well. And if a patient needs COVID-19 testing, what happens next?
Dr. Lozovatsky: We are able to participate in the system process of making sure that the patients qualify for the test if it’s necessary. And then the test can be ordered during the visit and routed to our testing centers and once the order is place, the patient can go to the testing center and get the test completed if necessary.
Host: As we wrap up, let pediatricians and other providers know what you’d like them to know about the virtual pediatric respiratory emergency department visits and when they should refer their patients to this very important service at St. Louis Children’s Hospital.
Dr. Lozovatsky: I would like everyone to consider this service when they have a patient who could benefit from being assessed by a physician especially in the pediatric population where we know that the symptoms of COVID-19 are not always as clear as they are in the adult population. And they concerns about having that patient go to the emergency room and be exposed to other infections as well as exposing others. So, the goal here is to decrease exposure for the patient, for the family and for all of our providers and be able to safely provide this care via video where a physician can assess the patient, decide if they need testing and also decide if they need to be looked at in person and refer them to a safe location to make sure that the children stay as safe as possible as do their families.
Host: Thank you so much Doctor, for coming on and telling us about this very important and vital service at this time. You can find out more information about the service by visiting our site at www.stlouischildrens.org. That concludes this episode of Radio Rounds with St. Louis Children’s Hospital. To consult with a specialist or learn more about services and resources please call the Children’s Direct Physician Access Line at 1-800-678-HELP. Please remember to subscribe, rate and review this podcast and all the other St. Louis Children’s Hospital’s podcasts. I’m Melanie Cole.
Virtual Pediatric Respiratory ED Visits
Melanie Cole (Host): This is the St. Louis Children’s Hospital Podcast on COVID-19 dated April 27, 2020.
The COVID-19 pandemic has changed the way many of us are delivering care to our pediatric population. In an effort to keep patients, families and caregivers safe from possible exposure to the virus, St. Louis Children’s Hospital is now offering virtual emergency department visits for pediatric patients who are experiencing respiratory symptoms. This is Radio Rounds with St. Louis Children’s Hospital. I’m Melanie Cole and today, we’re discussing virtual pediatric respiratory ED visits during COVID-19 and how your patients can access this service. Joining me is Dr. Margaret Lozovatsky. She’s the Chief Medical Information Officer at St. Louis Children’s Hospital and she’s an Associate Professor of Hospitalist Medicine at Washington University School of Medicine. Dr. Lozovatsky, I’m so glad to have you with us and what an important topic. Tell us a little bit about this new service and how it came about.
Margaret Lozovatsky, MD (Guest): I am very enthusiastic about telling you how we developed this new service and how we think that it can be incredibly helpful for our patients. We realized as the COVID pandemic became a big crisis in our community, that all of our patients will be impacted. The pediatric patients are impacted at a lower rate than the adult population however, as we know, many pediatric patients experience respiratory symptoms especially during the flu and cold season that we were experiencing at the beginning of this. And so we wanted to provide an opportunity for all of those patients who may be symptomatic to receive their care at home in a safe environment.
Host: You mentioned that it’s a little bit more rare to see it in the pediatric population, but you are seeing flu and various other respiratory rotavirus, there’s all kinds of things going around with kids. So, tell us about the prevalence of COVID-19 in the pediatric population. What have you seen?
Dr. Lozovatsky: We sometimes don’t know for sure is the exact prevalence in the pediatric population because what we’re finding is that many kids have symptoms that are consistent with the presentation of COVID-19, however, because some of the symptoms may be more mild, those kids are not always tested. And so, even though we are seeing positive tests in the pediatric population, we know that there is a possibility that many more are impacted. We also know that kids don’t come to the hospital by themselves. They have their families to bring them and so those family members may also be affected by the COVID-19 pandemic and we know that keeping the whole family at home will decrease their exposure.
Host: Well we certainly have now reframed who we thought was at risk at this point. So, who should be using these virtual ED visits? Tell us a little bit about the procedure and how they get referred and really what happens.
Dr. Lozovatsky: We wanted to make the service available to as many patients as possible. So, we know that our pediatric offices are seeing their patients sometimes in the office and sometimes virtually. And in order to decrease exposures in those offices, and also to decrease exposures in our emergency department, we wanted to make sure that patients who are safe to be looked at via video who are stable enough and in a condition that does not require an emergency department visit, would have an opportunity to be seen by a physician, assessed via video to determine next steps.
Host: So, then how can a patient access this service, and do you have to be an existing patient to use the service? Tell other providers and pediatricians when their families call them and say I think we need to go to the ER, tell them how this works and what’s the next step.
Dr. Lozovatsky: There are several ways to get to My Chart where this is available. And I will talk you through the different ways that our patients can access the service. As a first step, I’d like to explain what My Chart is. So, that is our patient portal. Anybody can have an account in My Chart. They can access to be able to then log in, look at their child’s chart and in their child’s My Chart account, there is a symptom checker. They can go through the symptom checker to make sure that they qualify for these visits and that essentially means that they are safe enough to not need to bring their child in to be seen in person at that moment. And they can at that time, request an ED video visit and a physician will at that point, right away, be able to see them. And that physician can also order the test for them if needed.
And so to back up about how do you get to My Chart if you don’t already have it. We have spent a lot of time during this pandemic making sure that we have a way for as many patients as possible to be able to access this service. We now have a pathway for pediatric patients from Missouri to be able to create a My Chart account if they don’t have one. So, if they are not a patient of ours, there is a My Chart help desk number that they can call, and someone will talk them through making this account.
In the adult population of course, one makes an account for themselves. For kids, this is a little bit more complicated. And so the My Chart help desk has been trained to work with families that have kids of different ages and address their needs based on the age of the child. Anyone under the age of 11, will have a parental account so they are able to make an account for the parent if the parent doesn’t have one. And then the parent will request to have proxy access to their child’s account meaning that child account will be attached to theirs. And that can all be done with one phone call.
And then in our adolescent population, they can actually have their own account and so the team will speak with the adolescent, request their email and be able to send them an activation link to their email again in real time so that account can be created right away and these ED video visits can be accessed immediately.
Host: So, then who is providing care to the patient? Is it one of the ED docs? Who is doing that?
Dr. Lozovatsky: So, these services are provided by emergency room physicians, hospitalist physicians, and other pediatric subspecialists. We have a schedule where the majority of the time it’s an emergency room physician or another physician that has pediatric training that practices in our emergency department.
Host: Well that’s very reassuring for patients but for their pediatricians as well. And if a patient needs COVID-19 testing, what happens next?
Dr. Lozovatsky: We are able to participate in the system process of making sure that the patients qualify for the test if it’s necessary. And then the test can be ordered during the visit and routed to our testing centers and once the order is place, the patient can go to the testing center and get the test completed if necessary.
Host: As we wrap up, let pediatricians and other providers know what you’d like them to know about the virtual pediatric respiratory emergency department visits and when they should refer their patients to this very important service at St. Louis Children’s Hospital.
Dr. Lozovatsky: I would like everyone to consider this service when they have a patient who could benefit from being assessed by a physician especially in the pediatric population where we know that the symptoms of COVID-19 are not always as clear as they are in the adult population. And they concerns about having that patient go to the emergency room and be exposed to other infections as well as exposing others. So, the goal here is to decrease exposure for the patient, for the family and for all of our providers and be able to safely provide this care via video where a physician can assess the patient, decide if they need testing and also decide if they need to be looked at in person and refer them to a safe location to make sure that the children stay as safe as possible as do their families.
Host: Thank you so much Doctor, for coming on and telling us about this very important and vital service at this time. You can find out more information about the service by visiting our site at www.stlouischildrens.org. That concludes this episode of Radio Rounds with St. Louis Children’s Hospital. To consult with a specialist or learn more about services and resources please call the Children’s Direct Physician Access Line at 1-800-678-HELP. Please remember to subscribe, rate and review this podcast and all the other St. Louis Children’s Hospital’s podcasts. I’m Melanie Cole.