456 - Strengthening Telehealth Engagement to Promote IN-person visits (STEP-IN)

Publication Number: 4447.456

Jennifer McAllister, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Tanya E.. Cahill, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Deborah A. Borchers, CCHMC NICU follow up clinic, Ft. Mitchell, KY, United States; Elizabeth Robinson, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Tanya L. Staton, Cincinnati Children's Hospital Medical Center, Independence, KY, United States

Background: Children with prenatal opioid exposure are at risk for medical and developmental problems. Comprehensive follow-up care to evaluate and screen for issues specific for this population is important and recommended by the American Academy of Pediatrics. However, families affected by opioid use often face socioeconomic barriers in obtaining healthcare. Strategies to help address these challenges are needed to ensure the best outcomes for this high-risk population.

Objective: The aim of this study was to evaluate the impact of instituting telehealth visits after birth hospitalization on show rates of first in-person visits for infants with prenatal opioid exposure seen in the Supporting Those with Exposures Prenatally (STEP) Follow-up Clinic.

Design/Methods: This is a retrospective, cohort study of children seen in the STEP Clinic, a multidisciplinary medical and developmental follow-up clinic providing care for infants with prenatal opioid exposure, from January 2025-September 2025. As part of a quality improvement initiative to increase compliance with clinic visits, STEP Clinic referrals were placed and appointments were scheduled prior to the infant's discharge from the birth hospital. These appointments included a new telehealth visit which was scheduled within the first 1-2 weeks after discharge along with the first in-person clinic visit around 1 month after discharge. Among those who were scheduled for a telehealth visits, show rates for first in-person visits were tracked between those who completed and did not complete the telehealth visit and then compared to baseline show rates.

Results: Of patients referred to STEP Clinic, rates of those scheduled for telehealth increased from 0-72% with a median of 45% during the study period (Figure 1). The average rate of telehealth visit completion was 70% (Figure 2). Show rates of first in-person visits for those who completed a telehealth appointment increased from a baseline of 51% to 67% whereas those who did not complete a telehealth appointment had a decrease in show rate from 51% to 43% (Figure 3).

Conclusion(s): In our study, instituting telehealth after hospital discharge improved show rates for subsequent in-person visits for those who completed the telehealth visits. Engaging caregivers of infants with prenatal opioid exposure through telehealth may help identify and reduce barriers to care, increase buy-in on the importance of specialized follow-up, and ultimately improve outcomes for this population. Further efforts should focus on reasons for non-completion of telehealth visits as these families may be less likely to receive additional care.

Figure 1
Run chart of percent of patients with prenatal opioid exposure referred to STEP Clinic and scheduled for an initial telehealth visit.

Figure 2
Run chart of percent of STEP patients who were scheduled for telehealth and completed a telehealth visit.

Figure 3
Run chart of those who did and did not complete a scheduled telehealth visit and their compliance or show rate for the subsequent first in-person visit compared to initial baseline show rates for STEP Clinic.