Background: During the COVID-19 pandemic, telemedicine use has increased within community pediatrics. This trend runs counter to reluctance to adaptation of the new mode of healthcare that existed prior to the pandemic. Little is known about what we can expect after the pandemic: if physicians will opt for telemedicine modalities and if tele-pediatrics will continue to be a significant mode of community pediatric care. Objective: The goal of this study was to survey primary pediatric care providers as to their experiences and clinical decision making with telemedicine modalities prior to and during the COVID-19 pandemic, as well as their projected use after the pandemic ends. Material and methods: Using the EAPRASnet database we surveyed pediatricians throughout Europe, using a web-based questionnaire. The survey was performed during the COVID-19 pandemic (June-July 2020), assessed telemedicine use for several modalities, prior to and during the pandemic as well as predicted use after the pandemic will have resolved. Participants were also surveyed regarding clinical decision making in two hypothetical clinical scenarios managed by telemedicine. Results: A total of 710 physicians participated, 76% were pediatricians. The percentage of respondents who reported daily use for at least 50% of all encounters via telemedicine modalities increased during the pandemic: phone calls (4% prior to the pandemic to 52% during the pandemic), emails (2-9%), text messages (1-6%), social media (3-11%), cell-phone pictures/video (1-9%), and video conferencing (1-7%) (p < 0.005). The predicted post-pandemic use of these modalities partially declined to 19, 4, 3, 6, 9, and 4%, respectively (p < 0.005), yet demonstrating a prospectively sustained use of pictures/videos after the pandemic. Reported high likelihood of remotely treating suspected pneumonia and acute otitis media with antibiotics decreased from 8 to 16% during the pandemic to an assumed 2 and 4% after the pandemic, respectively (p < 0.005). Conclusions: This study demonstrates an increased utilization of telemedicine by pediatric providers during the COVID-19 pandemic, as well as a partially sustained effect that will promote telemedicine use as part of a hybrid care provision after the pandemic will have resolved.

Adelson School of Medicine Ariel University Ariel Israel

Andrija Štampar School of Public Health School of Medicine Univeristy of Zagreb Zagreb Croatia

Biostatistics Unit Cyprus Institute of Neurology and Genetics Nicosia Cyprus

Centro Médico Pere Grau Barcelona Spain

Department of Hygiene and Epidemiology Faculty of Public Health Medical University of Varna Varna Bulgaria

Department of Medicine European University Cyprus Nicosia Cyprus

Department of Paediatrics Regional Hospital AZ Damiaan Ostend Belgium

Department of Paediatrics University Hospital Ghent Ghent Belgium

Department of Pediatrics and Pediatric Endocrinology and Diabetes Medical College University of Rzeszow Rzeszow Poland

Department of Pediatrics Hospital Beatriz Ângelo Loures Portugal

Department of Pediatrics Medical University Graz Graz Austria

Department of Pediatrics School of Medicine National and Kapodistrian University of Athens Athens Greece

Department of Pediatrics Shupyk National Medical Academy of Post graduate Education Kyiv Ukraine

Health Center Domžale Domžale Slovenia

Institute of Clinical Medicine Medical Faculty Vilnius University Vilnius Lithuania

Kinderaerzte Kurwerk Burgdorf Switzerland

Maccabi Healthcare Services Tel Aviv Yafo Israel

Meuhedet Health Services Tel Aviv Yafo Israel

Paediatric Clinic Budapest Hungary

Paediatric Clinic Hagen Germany

Paediatric Clinic Prague Czechia

Pediatria Childcare Worldwide Padova Italy

Pediatria di Famiglia Federazione Italiana Medici Pediatri FIMP Naples Italy

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