Paediatrics clinics seem to have an easier time scaling up with online consultations and making them an organic part of their patient pathways, especially since the target group of parents is so positive.
Digital transformation has created new expectations from people who are active users of various digital services. As private actors are pushing for high demand in the first line of care, it affects healthcare overall. The population group who was the fastest to take up online consultations were the parents.
Seeking care for their children
A research study from the Swedish Association of Local Authorities and Regions in collaboration with Jönköping University from 2019 showed that 40% of the patients from online consultations in primary care in the Jönköping County region were children. The survey was conducted on 10,400 people who have been in contact with doctors digitally via private digital healthcare providers or the region’s own digital primary care clinic Bra Liv nära. 
The optimistic 30+
Another report ‘Digital transformation for everyone: Ensuring more adults experience the benefits of NHS online consultations’ from 2020 also shows that the ‘parent generation’ aged 30–49 are the second most active group in booking online consultations, for themselves and their children. The interesting part here is that male respondents between 18–49, i.e. fathers, are the group most likely to have had an online consultation for their child, thus involving them more in their child’s care. In the same age group, 50% agree or fully agree that online consultations make accessing healthcare more straightforward to them. The group shows a pattern of generally being more positive than average about digital tools in healthcare; they identify avoiding travelling, a minimised risk of infection, and shorter waiting times as the main advantages with online consultations. 
Parents find online consultations easier
We see many examples of how paediatrics clinics succeed in implementing online consultations successfully. They all remark on the parents’ attitude as an important success factor. Many parents are relieved when they are given the opportunity to make a follow-up appointment or a group appointment online. On a hectic weekday, it can be difficult to spare a whole or even half a day to go to the reception. But a 30-minute video consultation has a higher likelihood of attendance, with minimal problems. It is also often the case that both parents have the chance to participate, so the treatment result can be considerably better with both parents involved.
Healthcare professionals also see good opportunities in shorter and more frequent follow-ups with parents being remote.
I don’t think that anything slips through the cracks in conversations with parents by having an online consultation instead of on-site. And once the family has started practising and knows what to do, digital follow-up appointments may suffice for a good while.
That’s what Emelie Grönfors, a speech therapist at Queen Silvia’s Children and Adolescents’ Hospital, says.
Collaboration around the children
Our platform statistics from several clinics that work with children show them at the top for the use of multi-party calls. There are often more people involved when it comes to children; through parents, cross-functional healthcare teams and collaborations with school counsellors and healthcare. It is a strong incentive for healthcare professionals to book and have video consultations with several participants and to collaborate around the patient in a good way.
The rehabilitation centre in Jönköping is one of the clinics that use multi-party calls extensively for collaborative care plan appointments. In March 2021, they conducted 75% of these types of appointments (a total of 170) digitally. It may not continue to be that much after the pandemic, according to Deputy Operations Manager Mårten Ärlig, but healthcare staff believe that it is a form of appointment with great value of having it online – something that would otherwise result in a lot of travel time for several different people.
That is where the most visible benefits are and the consultation quality remains high, since we are so used to meeting digitally now.
Online consultations require less energy
Furthermore, Mårten says that online consultations can, in some cases, be a better format for their patients. Children and young people with little energy may have difficulty participating in long appointments at the reception and some of their energy may have been expended already along the way.
When they come to us, we want to take the opportunity to do what we are supposed to when patients are there. But it does not always suit the patient so well. When we have an online consultation, the child can leave and rest in their room for a while and we can continue talking to the parents.
A study from the Cystic Fibrosis centre in Gothenburg, working with families with children with Cystic Fibrosis, also shows that parents and children save time and energy with online consultations. One mother says that her child was happy and full of energy after the online consultation, instead of being exhausted and cranky after spending a whole day at the clinic, including travel time. The study also showed that it is possible for children to perform certain tests from home. Both the children and their parents were positive and wanted to continue with online consultations after the study ended. 
More focused appointments
A consultation through a screen will be different. With young children, it can be difficult to make them understand that it is a real person they are conversing with, while older children are used to making video calls to grandma and grandpa. Emelie, a Speech Therapist, always asks the parent to stay in the room, so that they can remind the child to focus during the consultation. Parents play a more active role in the online consultation; they can pick out games and toys and do what the speech therapist usually does with their hands. Emelie says:
They need to have full focus on what we do together and become very involved in the activity and often become familiarised with exercises for their child.
Mårten Ärlig also talks about how the dynamics become different in an online consultation when the social codes disappear.
In some cases with a screen, the healthcare professional is more focused on the patient than they could have been in a physical appointment. When there are 3-4 people in a room, everyone more or less automatically takes up the same amount of space, but in an online consultation you can focus on the patient.
One of the biggest benefits of online consultations is fewer DNAs. In cases of children and parents, the risk of DNA is even greater. Using the benefit of booking or rebooking an online consultation, many appointments that would have otherwise been missed can take place online. At heavily booked receptions, it is worthwhile to be able to continue the treatment as planned and not having to find a new time.
Another example of saved appointments thanks to the digital tools are children and young people who would rather avoid the appointment completely. There are several diagnoses, but also times in life, where it can be a challenge to go to a clinic with the parents. In these cases, an online consultation on the child’s mobile in their own room, on their own terms, is an alternative – definitely, a better alternative than a forced physical appointment or no appointment at all.
Driving change with those who want it
It is easier to change together with those who are willing or perhaps even ask for a change. Parents, children, and young people have discovered that online consultations can help to provide good healthcare, without having to arrange their lives around a physical appointment. When patients are satisfied, healthcare professionals are more motivated, and these two strong forces drive the development of online consultations and the will to make them an organic part of the patient pathways. No wonder we see high activity at clinics that work with children and their parents.