A Phone Call Away
Telemedicine becomes a pandemic success story
by Jessica Gregg
A nother way that the coronavirus has changed our world ? Telemedicine.

Prior to this year, most of us had never been on a video call with our physicians. But with stay-at-home
orders and limited patient hours at many physician practices this spring, parents experienced Zoom or Skype
appointments with obstetricians, pediatricians and other doctors.

At Baltimore’s Mt. Washington Pediatric Hospital, psy-
chologists found telemedicine to be a valuable tool. It’s one
they had long hoped to use for counseling sessions, says
Dr. Kenneth Gelfand, the hospital’s psychology manager.

The hospital sees young patients from all over the state with
a variety of medical issues, including feeding disorders, autism
and long-term medical conditions. Its counseling staff con-
ducts about 25,000 patient visits each year.

For families with transportation issues or children who
are immunocompromised, for example, the hospital’s
practitioners had long hoped to serve patients through telep-
sychology. It was something for which his team had advocated
40 Washington FAMILY JULY 2020
for years, Gelfand says. When staff had to shift gears in mid-
March because of the pandemic, the chance to try telemedicine
reinforced the ways it could be useful.

“For a lot of families, this really has created an equivalent
level of care,” Gelfand says.

Many of the hospital’s teenaged patients had an “increased
interest” in their appointments, because they didn’t have to
take the time from busy schedules to come in for appoint-
ments, he says. For patients with anxiety, counselors were
often able to talk with them as the anxiety was happening and
give them in-home strategies for coping and alleviating it.

Visits were conducted by Zoom, and with small children,



staff did have to be “creative,” Gelfand says.

Psychologists engaged kids with online games
and activities, multimedia and the help of fam-
ily. Many patients provided tours of their homes
or introduced their pets, so practitioners got to
learn firsthand about that child’s daily life. For
kids with feeding disorders, psychologists could
see them eating in their kitchens and offer valu-
able feedback and hints.

There were adjustments, of course.

Implementing this new tool with patients
with autism was initially challenging, Gelfand
admits. Many children with autism found the
changes in daily life during the pandemic to
be stressful. But telepsych visits eventually
provided structure for home and family, he says.

After the pandemic, hospital staff hopes that
10 to 20 percent of its counseling visits will
continue to be conducted remotely. Face-to-face
sessions remain important, of course, but telep-
sych can continue to be a tool for patients with
transportation and other barriers, Gelfand says.

“In whatever a post-COVID world brings,
telepsychology remains a tool for practitioners
to use,” he says.

LUNAR_CAT / ISTOCK / GETTY IMAGES PLUS
Helping military families
Before the pandemic, behavioral psychol-
ogists at Kennedy Krieger Institute in
Baltimore used telehealth with military
families at Fort Meade, Fort Detrick and
Aberdeen Proving Ground through a pro-
gram the hospital started in 2016, says Dr.

Jennifer Crockett, director of training
with the department of behavioral psy-
chology. The program later expanded
to include families at Naval Air Station
Patuxent River.

“Telehealth has such great appli-
cability to military families, because
it’s portable,” Crockett says.

And because Kennedy Krieger
had success with this program,
they were able to scale it up
for other departments when
COVID-19 hit. In fact, Crockett
co-chaired a task force to make sure this
happened. Practitioners in every department, even physi-
cal and occupational therapies, have been able to
work with their patients via telehealth. This also
includes inpatient services, Crockett says, adding
that a practitioner at a child’s bedside can use
technology to connect with a speech therapist,
a physical therapist and a parent to talk through
that child’s care needs.

“We find children take to it well,” she says.

But so do parents. Crockett often works with
children as young as 2. In those instances, a
telehealth call centers on coaching the parent
in behavioral strategies rather than engaging a
child who might not be interested in Zoom.

“One of the benefits that we suspected we
would see, and we have seen, is that parents are
saying, ‘I’m getting this quicker now because
I’m doing it,’” Crockett says. “They are not
watching us do something. They’re doing it, and
they’re doing it in their own homes.”
Telehealth also has been a good way for
practitioners to connect with children feeling
anxious because of the extreme disruptions in
their life.

“We’ve seen an increase in COVID stressors,
so some of things we are doing are specific to
what is happening in the world right now,”
Crockett says.

In addition to its inpatient and outpatient
services, Kennedy Krieger also has a school
program that provided distance learning to its
students this spring.

“Oftentimes people think that kids with
special needs can’t use technology,” says
Lisa Nickerson, assistant vice president of
marketing, public relations and communica-
tions. But that would not be true, she adds.

With the help of their parents
and teachers, students com-
pleted many lessons through
tele-education. Like other schools, the big-
gest issue was accessibility; not
all students had computers. That’s
something the hospital works hard
to overcome with its patient families.

Crockett says she looks for grants that
allow the hospital to purchase laptops
that can be loaned to patient families as
well as other ways to improve access to
care. She adds that families should not be
deterred from seeking help for their child
because of technology.

And after COVID-19? Crockett hopes that
telehealth remains a care option for Kennedy
Krieger patients.

“There’s still so much that is unknown,”
she says. We’re still working every day to con-
tinue to ramp up the process. COVID gave us
the opportunity to jump into telehealth. I hope
people see the value in it.” T
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