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Ambulatory cardiology telemedicine: a large academic pediatric center experience
  1. Aaron A Phillips1,
  2. Craig A Sable2,3,
  3. Shireen M Atabaki2,4,
  4. Christina Waggaman5,
  5. James E Bost2,5,
  6. Ashraf S Harahsheh2,3
  1. 1Pediatrics, Children's National Hospital, Washington, DC, USA
  2. 2Department of Pediatrics, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
  3. 3Division of Cardiology, Children's National Hospital, Washington, DC, USA
  4. 4Division of Emergency Medicine, Children’s National Hospital, Washington, DC, USA
  5. 5Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, USA
  1. Correspondence to Dr Ashraf S Harahsheh, Department of Pediatrics, Division of Cardiology, Children's National Hospital/ George Washington University School of Medicine & Health Sciences, Washington, DC, USA; aharahsh{at}


We performed a retrospective study of cardiology telemedicine visits at a large academic pediatric center between 2016 and 2019 (pre COVID-19). Telemedicine patient visits were matched to data from their previous in-person visits, to evaluate any significant differences in total charge, insurance compensation, patient payment, percent reimbursement and zero reimbursement. Miles were measured between patient’s home and the address of previous visit. We found statistically significant differences in mean charges of telemedicine versus in-person visits (2019US$) (172.95 vs 218.27, p=0.0046), patient payment for telemedicine visits versus in-person visits (2019US$) (11.13 vs 62.83, p≤0.001), insurance reimbursement (2019US$) (65.18 vs 110.85, p≤0.001) and insurance reimbursement rate (43% vs 61%, p=0.0029). Rate of zero reimbursement was not different. Mean distance from cardiology clinic was 35 miles. No adverse outcomes were detected. This small retrospective study showed cost reduction and a decrease in travel time for families participating in telemedicine visits. Future work is needed to enhance compensation for telemedicine visits.

  • cardiology
  • cardiovascular diseases
  • heart defects
  • congenital
  • heart diseases

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  • Presented at the 2019 American Heart Association Annual Scientific Sessions

  • Contributors AAP was involved in study design, data gathering, analysis of data and drafting the manuscript. CAS was involved in study design and manuscript revision. SMA was involved in study design, data gathering and manuscript revision. CW and JEB were involved in the analysis of data and revising the manuscript. ASH was involved in study design, data gathering, analysis of data and revising the manuscript. This submission is with the full knowledge and approval of the listed coauthors.

  • Funding This study was funded in part by a grant from the BlueCross BlueShield CareFirst Foundation, “Expanding Access to Medical Care Through Telemedicine”.

  • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the local Institutional Review Board with a waiver of consent.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Author note Dr Aaron A. Phillips is currently a pediatric cardiology fellow at Lucile Packard Children’s Hospital Stanford Children’s Health, Palo Alto, CA, USA.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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