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PEDIATRICIANS’ KNOWLEDGE OF CONCUSSION AND BARRIERS TO THE IMPLEMENTATION OF TELEHEALTH IN ARKANSAS

Abstract

Katie Stephenson-Brown1, R.J. Elbin1 1University of Arkansas, Fayetteville, AR

Eighty-two percent of concussed adolescents seek care from their pediatrician, which provide care for a wide array of health problems. Some concussions may require specialty knowledge and referral. The assessment, management, and treatment of concussion requires a multifaceted management and treatment, which may not be accessible to the patient. The knowledge, clinical care, and telehealth usage are understudied in pediatricians. PURPOSE: To document concussion knowledge, clinical care, and usage of telehealth in pediatricians. METHODS: Sixty-two pediatricians (45.80 ± 12.77 yrs; 53% female) completed a survey that assessed concussion clinical care and knowledge. Qualitative items explored current usage of telehealth for concussion referral. RESULTS: The majority (82%, 51/62) of pediatricians provided care for patients with concussion. The most frequent concussion assessments used by pediatricians were the clinical exam (94%, 48/51), paper-and-pencil cognitive testing (67%, 34/51), vestibular/ocular-motor evaluation (18%, 9/51), and computerized neurocognitive batteries(4%, 2/51). All pediatricians reported “above average” knowledge, and the majority (66%, 41/62) reported being confident or highly confident in diagnosing concussions. More than half (52%, 32/62) of pediatricians used grading scales for concussion management, and most pediatricians (69%, 43/62) had access to telehealth technology for specialty referral, but only 26% (11/43) used it in their practice. Commonly reported barriers for implementing telehealth for concussion referral was lack of training and compensation for referrals to telehealth sources. CONCLUSION: The clinical assessments used by pediatricians are lacking. Further, there is a need to provide training and resources for doctors to learn about telehealth.

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