The first findings from a large, NIH-funded research programme launched in 2023 suggest that telemedicine is becoming an established part of pediatric primary care, particularly for children with chronic endocrine and behavioral health conditions. Researchers at Children's Hospital of Philadelphia (CHOP) report that virtual consultations are increasingly being used where ongoing follow-up is essential and may even enable practices to care for more patients without replacing face-to-face visits.
The findings, published in the Journal of Pediatrics, are among the first results emerging from the Telemedicine Integrated into Pediatric Primary Care & Child Outcomes (TIPP-C) programme, a multi-year study led by pediatrician and researcher Alexander Fiks. The programme was established to determine when telemedicine delivers care comparable to, or better than, traditional in-person consultations, while also examining its impact on child health outcomes and health equity.
Chronic conditions lead telemedicine adoption
The researchers analysed electronic health records from 1,088 pediatric practices across the United States, covering more than 19.6 million problem-based consultations between 2019 and 2024.
Telemedicine accounted for less than one percent of visits before the COVID-19 pandemic, peaked at 55 percent during April 2020 and stabilised at around six percent of consultations by 2024. Rather than disappearing after pandemic restrictions ended, virtual care has found a more targeted role within pediatric primary care.
Behavioral health consultations showed the highest telemedicine use (20%), followed by endocrine disorders (19%), dermatology (11%), infectious diseases (11%), digestive health (10%) and respiratory conditions (9%). According to the researchers, these are clinical areas where regular follow-up is important but comprehensive physical examination is only occasionally required, allowing telemedicine to reduce travel time and scheduling burdens for families.
The study also suggests that practices increasingly use telemedicine to expand capacity. Since mid-2023, every additional telemedicine consultation has been associated with an increase in overall visit volume, indicating that virtual care may allow more children to receive timely treatment.
"This study has helped us clarify the role of telemedicine and its impact on problem-based care," said Fiks. "We still need studies to investigate how these increased telemedicine visits impact child health outcomes while also reducing the burdens and access barriers families may face when seeking quality care for their children."
From research questions to first answers
The new publication represents an important milestone in the TIPP-C programme announced by CHOP in 2023. At the time, Fiks and colleagues noted that although telemedicine use had expanded rapidly during the COVID-19 pandemic, there was little evidence to guide when virtual consultations should be preferred over in-person care.
The NIH-funded programme was designed to address three key questions: how telemedicine compares with face-to-face consultations across preventive, acute and chronic care; how different levels of telemedicine use influence long-term child health outcomes and health equity; and which organisational structures and clinical workflows lead to the most effective implementation.
The current Pediatrics study provides the first large-scale picture of how telemedicine is actually being integrated into routine pediatric primary care. The remaining phases of the research programme are expected to examine whether these changing patterns of care also translate into improved clinical outcomes, better access to care and reduced health inequalities.
