A study from earlier this year shows that commercial telehealth programs were over-prescribing antibiotics to children.
But telehealth experts emphasize that research and results like this are vital.
“Telehealth has amazing potential to impact the care of patients in a variety of situations," said Dr. David McSwain, one of the founding members of the telehealth program at the Medical University of South Carolina.
“We have to study it.”
Researchers with the American Academy of Pediatrics looked at a select group of children with acute respiratory infections and found that a little over 50 percent received antibiotics from a telemedicine provider.
Urgent care and primary care providers were seeing lower percentages. For primary care providers, just over 30 percent of the children received antibiotics.
The study also shows that primary care providers were more likely to follow antibiotic management guidelines than telemedicine providers and that telemedicine providers more often tended to prescribe antibiotics for viral infections, which is not effective.
Study authors note that organizations like the American Telemedicine Association have previously highlighted concerns with direct-to-consumer telemedicine care outside of a child's medical home.
“Our results support these concerns and underscore the importance of pediatric-specific evaluation and guidelines," the authors wrote in their published study.
According to the Mayo Clinic, an overuse of antibiotics can lead to the development of bacteria that is resistant to treatment. McSwain said if telehealth is going to be taken seriously, it has to be scrutinized in this manner.
“Without research on telehealth we are just making our best guess as to what is going to work and what isn’t," McSwain said.
Earlier this year, MUSC received a grant from the National Institutes of Health to be a part of a national collaborative project called the Supporting Pediatric Research on Outcomes and Utilization of Telehealth, or SPROUT.
McSwain, who is also a pediatrician at MUSC, is a part of the project's executive committee.
Through the SPROUT program, McSwain said they want to establish a culture of research around the development of telehealth.
The goal is to come up with the best practices for implementing pediatric telehealth.
The hope, McSwain said, is that the SPROUT program will add another layer of scrutiny.
As for an explanation for the over-prescribing, he believes commercial telehealth providers probably tend to give out more antibiotics because of lack of a relationship with patients. With primary care providers, they see these patients in person.
They also often have a history with their patients. So they have a better understanding of their health needs. This is why for any telehealth program that is going to see children, there needs to be communication with the primary care doctor, McSwain said.
This is also why he doesn't see this being a major concern for locally run teleheath programs. A typical requirement for these local programs is that the physicians meet the patients in person.
“Even for the smallest children, telehealth has great potential to impact their health positively," he said. “But as we develop these programs we have to do so very thoughtfully.”