197 - Impact of an Asynchronous Telehealth Specialist Clinic on Parental Time Burden for Receiving Ambulatory Asthma Care

Poster Number: 197
Publication Number: 197.74

Background: Adults spend an average of two hours seeking ambulatory care (travel and clinic time combined [38 and 86 minutes, respectively]), resulting in lost productivity and wages. For racial and ethnic minority groups, time burden is 25% higher without a concomitant increase in physician face time. Telehealth may provide an opportunity to limit the time burden that parents experience, particularly those seeking asthma specialist care.

Objective: We sought to understand the time burden associated with an SMS text-based asynchronous telehealth (SMS-T) asthma specialist care model.

Design/Methods: This is a secondary analysis of data collected in a clinical trial offering SMS-T asthma specialist follow-up care to parents of children 2–18 years old, presenting to the emergency department (ED) for asthma. Post-ED discharge, parents and adolescents completed asthma morbidity surveys (addressing disease trajectory and burden, interval exacerbations, adherence to controller medications, and asthma severity) every three weeks by SMS for three months. Time burden was measured as the minutes taken by participants to complete the asthma morbidity survey. We examined differences in survey completion times by sociodemographic and clinical characteristics reported at baseline.

Results: There were 145 participants, including 10% Black, 77% Hispanic, and there was a mean age of 6.5 years. Forty six percent of parents reported English was their primary language and 56% had a high school education or less. More than 80% of children had at least one asthma exacerbation in the prior 12 months (Table 1). The median survey completion time was 5.2 minutes. Participant race and ethnicity and number of asthma exacerbations were not associated with significant differences in survey completion time. Significant differences in survey completion time were observed among some groups; those whose primary language was Spanish, who had less than a high school education, and who had intermittent/mild persistent asthma severity had longer median survey completion times (Table 2).

Conclusion(s): Asynchronous telehealth asthma specialist care provided via SMS substantially reduced parental time burden in this population of racial and ethnic minority patients with high asthma morbidity compared to historical in-person ambulatory clinic visits. The impact of this care modality on parental financial costs is unknown.