# Telemedicine Integrated into Pediatric Primary Care & Child Outcomes

> **NIH NIH R01** · CHILDREN'S HOSP OF PHILADELPHIA · 2024 · $647,634

## Abstract

During the summer of 2021, 80% of pediatricians reported using live audio-video 
telemedicine in the prior month, up from 16% of pediatricians with telemedicine 
experience just four years before. The child health workforce now actively uses 
telemedicine to care for children, but lacks evidence to guide best practices for 
telemedicine use in pediatric primary care. Our research team previously found gaps in 
the quality of care delivered by commercial direct-to-consumer telemedicine for the 
most common acute pediatric concerns (acute respiratory tract infections). We also 
demonstrated improvement in management of common chronic conditions (e.g., 
asthma, attention-deficit/hyperactivity disorder) using telemedicine in research settings. 
However, the child health community lacks data regarding the use of telemedicine in 
evolving “real-world” primary care practices, including how telemedicine visits compare 
to in- person visits for the same conditions and how telemedicine use impacts 
longitudinal outcomes for primary care patients. Additionally, we lack understanding of 
the structures and processes that support primary care practices in using telemedicine 
in ways that optimally enhance child health. The overarching goal of this proposal is to 
identify actionable strategies for promoting the use of telemedicine within primary care 
in ways that improve child health, using data from primary care practices from 2018-25. 
In Aim 1, we will compare visit-level quality of primary care visits for children delivered 
through telemedicine vs. in-person using electronic health record data from over 1,000 
practices including independent practices, health system-affiliated practices, and 
community health centers. In Aim 2, we will compare child health outcomes for children 
receiving care in primary care practices with higher vs. lower telemedicine use through 
comparative interrupted time series analysis of metrics related to preventive, acute, and 
chronic care. Finally, in Aim 3, we will identify the practice structures and processes that 
promote or impede use of telemedicine in primary care in ways that improve child 
health through a qualitative multiple-case study. Through this rigorous mixed-methods 
approach informed by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 
model, we will identify visit-level and child-level impact of telemedicine integration 
within primary care for children as well as processes supporting health-promoting use 
of telemedicine. As a result, this examination of telemedicine across preventive, acute, 
and chronic care activities overall, for subpopulations, and within exemplar practices 
will provide critical knowledge to inform research, practice, and policy to optimize 
ongoing use of telemedicine within primary care to promote child health.

## Key facts

- **NIH application ID:** 10904779
- **Project number:** 5R01HD107153-03
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Alexander Gabriel Fiks
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $647,634
- **Award type:** 5
- **Project period:** 2022-09-15 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10904779

## Citation

> US National Institutes of Health, RePORTER application 10904779, Telemedicine Integrated into Pediatric Primary Care & Child Outcomes (5R01HD107153-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10904779. Licensed CC0.

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