Telehealth assessment and remote examination of children

Medical-home integration is a quality design choice, not a brand preference. Ray and colleagues linked paediatric direct-to-consumer telemedicine visits with higher antibiotic prescribing, and later work comparing primary-care versus direct-to-consumer telemedicine pathways continues to show stewardship differences. ^{[6] [7] [11]}

Overview & Definition

Imagine a parent rings because a toddler has fever and is “not right.” You cannot put a stethoscope on the chest. You cannot feel the abdomen. You can still do dangerous harm in two opposite ways: you can reassure too early, or you can treat uncertainty with an unnecessary antibiotic and no follow-up. Paediatric telehealth is the craft of deciding which problems can be assessed remotely, how to examine at a distance, and when to stop being virtual. ^{[1] [3] [17]}

Telehealth is the broader term for care delivered with telecommunications. Telemedicine often refers to clinician–patient clinical encounters. Remote patient monitoring is ongoing capture of patient- or family-generated data such as oxygen saturations, glucose or symptom scores. Store-and-forward means images or recordings are reviewed later. Telephone-only advice is still common and still limited. Name the modality you used in the notes. Do not write “full exam” when you only observed a video. ^{[2] [16] [30]}

AAP clinical reports after the pandemic expansion frame telehealth as a tool to improve access, quality and cost when it is designed well, and as a source of inequity and quality gaps when it is not. The fellowship task is not “can we do video?” It is “should we, for this child, and what is the conversion plan if we cannot finish safely?” ^{[3] [4] [5] [20]}

This page owns modality selection, remote assessment technique, webside manner, stewardship, equity, privacy and disposition after virtual care. It does not replace dedicated pages on the Paediatric Assessment Triangle, full physical examination, history technique, vital-sign norms or disease-specific treatment. ^{[3] [17]}

References30ShowHide

1. [1]Burke BL Jr Telemedicine: Pediatric Applications Pediatrics, 2015.PMID 26122813
2. [2]Olson CA The Current Pediatric Telehealth Landscape Pediatrics, 2018.PMID 29487164
3. [3]Curfman A Pediatric Telehealth in the COVID-19 Pandemic Era and Beyond Pediatrics, 2021.PMID 34215677
4. [4]Curfman AL Telehealth: Improving Access to and Quality of Pediatric Health Care Pediatrics, 2021.PMID 34462339
5. [5]Curfman A Telehealth: Opportunities to Improve Access, Quality, and Cost in Pediatric Care Pediatrics, 2022.PMID 35224638
6. [6]Ray KN Antibiotic Prescribing During Pediatric Direct-to-Consumer Telemedicine Visits Pediatrics, 2019.PMID 30962253
7. [7]Wittman SR Antibiotic Receipt for Pediatric Telemedicine Visits With Primary Care vs Direct-to-Consumer Vendors JAMA Netw Open, 2024.PMID 38483387
8. [8]Marcin JP Impact of Tele-Emergency Consultations on Pediatric Interfacility Transfers: A Cluster-Randomized Crossover Trial JAMA Netw Open, 2023.PMID 36780158
9. [9]Marcin JP Telemedicine vs Telephone Consultations and Medication Prescribing Errors Among Referring Physicians: A Cluster Randomized Crossover Trial JAMA Netw Open, 2024.PMID 38421649
10. [10]Schinasi DA Telehealth in pediatric emergency medicine Curr Probl Pediatr Adolesc Health Care, 2021.PMID 33551336
11. [11]Milne Wenderlich A Telehealth in pediatric primary care Curr Probl Pediatr Adolesc Health Care, 2021.PMID 33547004
12. [12]Erkkola-Anttinen N Smartphone Otoscopy Performed by Parents Telemed J E Health, 2019.PMID 30040525
13. [13]Shah MU iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents? Int J Pediatr Otorhinolaryngol, 2018.PMID 29447893
14. [14]Elliott T Conducting a Professional Telemedicine Visit Using High-Quality Webside Manner Curr Allergy Asthma Rep, 2022.PMID 35072928
15. [15]McConnochie KM Webside Manner: A Key to High-Quality Primary Care Telemedicine for All Telemed J E Health, 2019.PMID 30648924
16. [16]Foster C Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics Pediatrics, 2022.PMID 35102417
17. [17]Utidjian L Pediatric Telehealth: Opportunities and Challenges Pediatr Clin North Am, 2016.PMID 27017042
18. [18]Curfman AL Implementation and Evaluation of a Wraparound Virtual Care Program for Children with Medical Complexity Telemed J E Health, 2023.PMID 36355064
19. [19]Haynes SC Video vs Telephone Consultations for Pediatric Quality of Care in Emergency Departments Pediatrics, 2026.PMID 42409386
20. [20]Haynes SC Pediatric Telemedicine: Lessons Learned During the Coronavirus Disease 2019 Pandemic and Opportunities for Growth Adv Pediatr, 2022.PMID 35985702
21. [21]Finkelstein JB Pediatric Clinicians' Use of Telemedicine: Qualitative Interview Study JMIR Hum Factors, 2021.PMID 34860669
22. [22]Badawy SM Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research JMIR Pediatr Parent, 2020.PMID 32540841
23. [23]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review JBI Evid Synth, 2020.PMID 32813387
24. [24]Samuels-Kalow M Like a dialogue: Teach-back in the emergency department Patient Educ Couns, 2016.PMID 26597382
25. [25]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis Br J Gen Pract, 2025.PMID 39117428
26. [26]Katz AL Informed Consent in Decision-Making in Pediatric Practice Pediatrics, 2016.PMID 27456510
27. [27]Coble C Teaching SSHADESS Versus HEADSS to Medical Students: An Association With Improved Communication Skills and Increased Psychosocial Factor Assessments Acad Pediatr, 2023.PMID 36130691
28. [28]Schinasi DA One-Size-Fits All: A Scalable Solution to Formal Telemedicine Provider Training to Support the COVID-19 Pandemic Response Front Pediatr, 2021.PMID 33859970
29. [29]Don DM Prospective Evaluation of a Smartphone Otoscope for Home Tympanostomy Tube Surveillance: A Pilot Study Ann Otol Rhinol Laryngol, 2021.PMID 32627572
30. [30]Buchi AB Use of Telehealth in Pediatrics Prim Care, 2022.PMID 36357063