Moderated Poster

Poster, Podium & Video Sessions

MP32-02: Telemedicine Utilization in Pediatric Urology and Beyond

Saturday, May 13
9:30 AM - 11:30 AM
Location: BCEC: Room 252

Presentation Authors: Stephen Canon*, Ismael Zamilpa, Ashay Patel, Mary Marquette, Little Rock, AR

Introduction: Limited research is available evaluating utilization of telemedicine (TM) in pediatric urology. The Pediatric Health Information System (PHIS) database is comprised of claims data from 49 of the largest children’s hospitals in America, providing an opportunity for analysis of the current utilization of TM in pediatric urology.

Methods: Clinical Transaction ClassificationTM (CTC) is a proprietary system used by PHIS to categorize hospital billing for clinical, imaging, laboratory, pharmacy, supply, and other services in which Clinical Service Code 599120 is designated for TM. The PHIS database was queried for all patients 18 years of age and younger with CTC 599120 occurring between 2009-2016 for all clinical services using TM including pediatric urology. Variables collected include patient age group, patient ethnicity, clinic subspecialty, principal diagnosis, primary source of payment, and location of clinic. The number of telemedicine episodes observed for our institution and clinic subspecialty in the PHIS database also were compared to our internal chart audit.

Results: Six hospitals in the United States utilized TM in a total of 670 visits with a single hospital comprising 430 (64%) of those visits. Primary diagnoses varied, with only 70/670 (10.4%) episodes comprised of urologic diagnoses such as pyelonephritis, hydronephrosis, urinary calculus, renal cyst, vesicoureteral reflux, neurogenic bladder, urinary tract infection, renal agenesis, bladder exstrophy, gross/microscopic hematuria and others. The majority of encounters 400 (60%) were performed for neonates (<30 days) with none of the other age groups comprising > 15% of the encounters. The majority of visits were performed in Caucasian patients (429, 66%) relative to other ethnicities. Medicaid was the most common primary payment method in 472 encounters (71%). Although no TM encounters were entered into the PHIS database for our institution and service code, our internal audit demonstrated 63 total encounters for our service alone.

Conclusions: Telemedicine appears to be an underutilized tool in pediatric urology and pediatric medicine. Incorrect application of appropriate billing codes may underestimate the actual use of telemedicine in pediatric medicine based upon our institutional experience. Further research is needed to better understand the lack of utilization of telemedicine in pediatric urology as a means to improve on the delivery of healthcare.

Source Of Funding: None

Stephen Canon, MD

University of Arkansas for Medical Sciences

Stephen J. Canon, M.D. is a board certified urologist and an Associate Professor and is the 2010 inaugural recipient of the Arkansas Children’s Hospital Auxiliary and John F. Redman, M.D., Endowed Chair in Pediatric Urology at the University of Arkansas for Medical Sciences.

Dr. Canon is Chief of Pediatric Urology at Arkansas Children’s Hospital and is the UAMS Department of Urology Residency Program Director. He received his medical degree from the University of Texas Medical Branch and completed a fellowship at the Children’s Hospital in Columbus, Ohio. He is a native Texan who has spent time in the mid-south after completing his residency in urology at the University of Tennessee Health Science Center in Memphis, TN.

Dr. Canon provides treatment for all pediatric urological conditions including hypospadias, spina bifida, and kidney stones. He enjoys teaching the Urologic Residents of UAMS and is engaged in the education of residents on the pathophysiology and treatment of pediatric urologic diseases as well as the surgical techniques specific to the correction of pediatric surgical problems.

His current research interests include minimally invasive surgery procedures for pediatric urology patients, hypospadias, and the usage of electronic medical records in Pediatric Urology.

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