Breaking Barriers: A Novel Telehealth Model for Pediatric Emergency Aftercare

Presenter: Evie K. Cannon, MD, MPH

Return visits after pediatric emergency department (ED) discharge contribute to healthcare utilization and may affect patient and family experience.

This retrospective study evaluated Rapid Emergency Aftercare by Telehealth (REACT), a scheduled follow-up program for children requiring reassessment, closer monitoring, or caregiver support, at Vanderbilt Children’s Hospital between May 1, 2025 and February 28, 2026. Among 780 encounters, the mean patient age was 37 months (median 17 months), 76.7% were English-speaking, and 60.9% had Medicaid insurance. Overall, 62% of scheduled telehealth visits were completed, with follow-up occurring a median of 1 day after ED discharge (interquartile range [IQR] 1–2; mean 1.6 days). Completed visits lasted a median of 10 minutes (IQR 10–15; mean 12.2 minutes; n=482). The 72-hour ED return rate was 6.4% and was similar between patients who completed follow-up and those who did not. Family satisfaction was high, with a top-box score of 83.33%. Longer ED-to-telehealth intervals were associated with lower completion odds (adjusted odds ratio [aOR] 0.81 per day; 95% confidence interval [CI] 0.67–0.98; p=0.034), while White patients had higher completion odds than non-White patients (aOR 1.77; 95% CI 1.22–2.57; p=0.003). Primary language and insurance type were not independently associated with completion.

Overall, rapid pediatric ED telehealth follow-up was feasible with high satisfaction and low short-term ED return rates, although timely scheduling was associated with successful completion.

American Academy of Pediatrics (AAP) National Conference & Exhibition 2026, October 2–6, San Diego, California