Philadelphia, August 5, 2026 – A multi-institutional study led by researchers at Children's Hospital of Philadelphia (CHOP) found that telemedicine is becoming increasingly common for problem-based primary care, particularly for children with endocrine or behavioral health issues where chronic needs are significant. The availability of telemedicine may also help increase appointment volume so that more patients can be seen. The findings were published today in the journal Pediatrics.
In 2020, telemedicine allowed patients to keep up with their appointments during the pandemic. By mid-2020, 97% of primary care pediatricians reported using telemedicine, up from 15% in 2016. Telemedicine has the potential to bridge geographic barriers to care, improve access to specialists and assist patients with chronic conditions more nimbly. However, barriers to its widespread use persist, ranging from a lack of telemedicine devices and poor internet access for some families, challenging clinical workflows, and provider preferences in the office. Additionally, despite its increased use, there is limited evidence on how telemedicine is being used to deliver primary care to children, particular across specific health conditions.
"The increase in telemedicine adoption in 2020 was out of necessity due to the pandemic, but now there's an opportunity to see where its use is having the greatest impact," said lead study author Alexander Fiks, MD , a pediatrician and the Director of Clinical Futures and the Possibilities Project: Innovation in Pediatric Primary Care at CHOP as well as Director of the American Academy of Pediatrics Pediatric Research in Office Settings (PROS) network that was also involved in the study.
The researchers conducted a retrospective study using electronic health records (EHRs) from 1,088 practices with a patient population comprised of children under 18 years old receiving care at participating sites. The study included 19,633,472 problem-based visits – appointments aimed at addressing specific health complaints, chronic conditions or other issues – conducted between 2019 and 2024.
In the study, the researchers identified 6 clinical domains with the highest proportion of problem-based visits conducted via telemedicine throughout the study period. These included behavioral health (20%), endocrine (19%), dermatology (11%), infectious disease (11%), digestive health (10%), and respiratory health (9%). Enhancing access to ongoing care via telemedicine can supplement in-person care for situations that only periodically require a detailed physical examination, while also addressing family time constraints that often hinder access to care.
During the study period, the researchers noted several changes in the adoption of telemedicine. In 2019, telemedicine represented less than 1% of visits, peaked at 55% of visits in April 2020, and declined to 6% by 2024. From 2019 to May 2023, each additional telemedicine visit was associated with a non-significant net change in total visit volume, and after May 2023, each additional telemedicine visit was associated with an increase in total visit volume, suggesting that in recent years, more patients may be seen for problem-based visits as more practices routinely adopt telemedicine into their offerings.
"This study has helped us clarify the role of telemedicine and its impact on problem-based care," Fiks said. "We still need studies to investigate how these increased telemedicine visits impact child health outcomes while also reducing the burdens and access barriers families may face when seeking quality care for their children."
The study was supported by National Institutes of Health grant R01HD107153. Additional infrastructure funding was provided by the American Academy of Pediatrics and Health Resources and Services Administration of the US Department of Health and Human Services under grant U5DMC39344. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Fiks et al, "Telemedicine use in primary care for children: 2019-2024." Pediatrics. Online August 5, 2026. DOI: 10.1542/peds.2025.075498.
