Background: During the COVID-19 pandemic, there has been exponential growth in utilization of Telehealth (TH) clinics.  Given our broad geographic base, our particular subspecialty, Pediatric Electrophysiology (EP), became an early adopter of Telehealth clinics so as to offer continuous high-quality care to our patients.   Here we describe the implementation and early experience of our EP TH Program, assessing patient satisfaction, patient equity and inclusion (measured by geographical outreach) and sustainability.  

Methods: A retrospective chart review study was performed from scheduled TH encounters between March-August 2020 of a single Pediatric EP group in the Midwest. Data collected from the medical records included demographics, visit diagnosis, diagnostic testing, and billing data. Phone based patient satisfaction surveys were completed. 

Results: 118 Patients were seen in TH clinics with a wide variety of diagnoses with supraventricular/atrial tachycardias (n=41, 35%) and inherited arrhythmia syndromes (n=23, 20%) being most common. The mean distance from clinic was 95 miles (range 2.8-320 miles), with 43% of patients living more than 100 miles away from clinic. 172 diagnostic tests were performed pre-visit (n=102, 59%), during the visit (n= 17, 10%) or post-visit (n=53, 31%), including 15 EP studies. Time-based CPT codes were predominantly used for billing purposes (n=92, 78%). The generation of work relative value units (wRVU) were calculated from visits (220.5 wRVU) and testing (325.1 wRVU). Survey data demonstrated that 98% of patients surveyed were satisfied with their telehealth appointment and 99% had a clear understanding of their diagnosis.   

Conclusion: Pediatric EP TH clinics can provide care for a wide geographic patient population with diverse pathologies.  High patient satisfaction scores, significant downstream testing and subsequent wRVU generation suggest sustainability beyond the COVID-19 pandemic.