New process makes telehealth enrollment easier for children, adolescents

In these days of COVID-19, telehealth visits for Vanderbilt University Medical Center (VUMC) patients 12 and younger have increased from 3.9 per week to 795 per week, and for patients ages 13-17, from 2.5 per week to 220 per week.

For telehealth services at VUMC, patients log in to a patient portal, My Health at Vanderbilt (MHAV).

While a secure online process allows adults to enroll in MHAV remotely, due to various regulatory protections, children and adolescents had been required to enroll in person.

With oversight from the Privacy Office and the Office of Legal Affairs, new enrollment processes for children and adolescents launched on March 16.

Since then, MHAV enrollment for patients 12 and younger has increased tenfold, to 1,582 per week, and for patients ages 13-17 it has increased by 20%, to 527 per week.

In the Journal of the American Medical Informatics Association (JAMIA), a team from VUMC reports solutions for remote MHAV enrollment for children and adolescents.

According to the authors, design and implementation of online enrollment processes for these patients took only two days.

For families of established patients 12 and younger who already have a VUMC medical record, a telephone conversation now serves for remote enrollment. For new patients 12 and younger and for all patients ages 13-17, separate online applications were implemented.

After families complete these applications, staff use two-way video to verify identities through a government-issued ID.

For patients with non-biological parents or legal guardians, an additional section of the application allows legal representatives to submit paperwork demonstrating guardianship.

“Collaborative policies at the federal, state and organizational level will be necessary to ensure continued funding and development of telehealth capacity,” the authors wrote.

The study was led by third-year medical student Pious Patel and Trent Rosenbloom, MD, MPH, associate professor of Biomedical Informatics, who directs MHAV.

Co-authors include Jared Cobb, PhD, Deidre Wright, Robert Turer, MD, MS, Tiffany Jordan, MS, Amber Humphrey, MBA, Adrienne Kepner, JD, and Gaye Smith, MBA.