{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:15:51Z","timestamp":1788221751252,"version":"build-2803163510"},"reference-count":39,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                    <jats:p>We lack national data on the maturing clinical use of telemedicine (TM) in children\u2019s primary care. This manuscript describes patterns of TM use for problem-based visits overall, across clinical domains, and associations of use with clinic visit volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a retrospective repeated cross-sectional analysis using electronic health records from 1088 pediatric and family medicine primary care practices nationwide, including children aged less than 18 years who received care between 2019 and 2024. We assessed monthly TM use by measuring problem-based visits per 1000 active primary care patients and the proportion conducted via TM, overall and within 6 distinct clinical domains. Regression modeling evaluated whether TM visit volume was associated with an increase, no change, or decrease in total visit volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The study included 19\u2009633\u2009472 problem-based visits (6% TM, 55% Medicaid, 14% Spanish language). TM represented less than 1% of visits in 2019, peaked at 55% in April 2020, and declined to 6% in 2024. In 2024, TM represented 20% of endocrinology (including obesity) visits and 15% of behavioral health visits compared to only 3% of respiratory visits. From 2019 to May 2023, each additional TM visit was associated with a non-significant net change in total visit volume (\u22120.1, 95% CI, \u22120.3\u20130.2). After May 2023, each additional TM visit was associated with an increase in total visit volume (2.02, 95% CI, 1.67\u20132.37).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Within primary care practices, TM use continues to meaningfully contribute to problem-based care delivery with variation across time and clinical domains.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-075498","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:03:02Z","timestamp":1785888182000},"source":"Crossref","is-referenced-by-count":0,"title":["Telemedicine Use in Primary Care for Children: 2019\u20132024"],"prefix":"10.1542","volume":"158","author":[{"given":"Alexander G.","family":"Fiks","sequence":"first","affiliation":[{"name":"1Clinical Futures, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"2The Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janani","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"1Clinical Futures, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Wittman","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Kate","family":"Kelly","sequence":"additional","affiliation":[{"name":"1Clinical Futures, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Davis","sequence":"additional","affiliation":[{"name":"4Primary Care Research, American Academy of Pediatrics, Itasca, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Steffes","sequence":"additional","affiliation":[{"name":"4Primary Care Research, American Academy of Pediatrics, Itasca, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Harris","sequence":"additional","affiliation":[{"name":"4Primary Care Research, American Academy of Pediatrics, Itasca, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances M.","family":"Biel","sequence":"additional","affiliation":[{"name":"5OCHIN, Inc., Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigit","family":"Hatch","sequence":"additional","affiliation":[{"name":"5OCHIN, Inc., Portland, Oregon"},{"name":"6Department of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody","family":"Butto","sequence":"additional","affiliation":[{"name":"7Aurora Pediatrics, Anchorage, Alaska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everly","family":"Macario","sequence":"additional","affiliation":[{"name":"4Primary Care Research, American Academy of Pediatrics, Itasca, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan G.","family":"Yabes","sequence":"additional","affiliation":[{"name":"8Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dara D.","family":"Mendez","sequence":"additional","affiliation":[{"name":"9Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia E.","family":"Szymczak","sequence":"additional","affiliation":[{"name":"10Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W.","family":"Grundmeier","sequence":"additional","affiliation":[{"name":"1Clinical Futures, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"2The Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin N.","family":"Ray","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"2026083119580852400_r1","article-title":"American Medical Association","author":"Telehealth resource center: 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