TelePlay — More Than Just Child ’ s Play
Photo courtesy of Project Sunshine . by HANNAH BAEK , MEG KELLETT AND TOM JAMES , MD
Telemedicine has expanded beyond the expectations we had for this technology platform just two years ago . As recently as 2019 , a patient visit was a face-to-face event . There were some telemedicine services , primarily with those living in rural areas who could not get in for an appointment . Most of those visits were for behavioral health or dermatologic services . We now tend to have a stereotypic view of how telemedicine can fit into our practice where we arrange virtual and in-person visits into the daily schedule . That view is another method of treating our patients — one on one . There are some who will use videoconferencing with a small group focused on a single condition such as diabetic education .
But the platform can be used for telehealth , focusing on improving health in all its different aspects . The Office of the National Coordinator for Health Information Technology ( ONC ) has defined the difference :
“ While telemedicine refers specifically to remote clinical services , telehealth can refer to remote non-clinical services , such as provider training , administrative meetings , and continuing medical education , in addition to clinical services .” 1
Those non-clinical services do contribute to the overall health of the individual . The use of telehealth now expands the capacity of such services from only in person in an individual or group setting , but also to a larger audience and in more remote locations . In rural Kentucky , access to support groups , birthing classes or child life specialists can be a challenge with distance and tricky mountain roads . In urban Louisville , bus schedules and day care deserts may prevent people in need from getting to clinical or non-clinical services .
An important non-clinical service for children is play . During
the pandemic , children were more isolated at home . Education , social interactions and , for some , health all suffered . Pediatricians and family physicians all recognize the importance of play as key in childhood development . For those children with chronic diseases or disabilities , play improves the child ’ s overall health status . When a child gets admitted to the hospital or receives a long-term diagnosis , the child and their family face a wide range of disruptions and threats to their overall well-being including “ interruptions in routines and relationships , isolation from home and community life , loneliness , fear , pain , and loss of autonomy .” Studies also show that children with medical challenges are at greater risk for future mental health and social problems . 2 , 3
Evidence is clear that play is a “ conduit for healing and healthy processing of events and information , and an essential intervention in pediatric healthcare settings .” Providing opportunities for children to play during hospitalizations or illnesses helps normalizes an unfamiliar and scary setting and circumstance . Another study describes play as a “ cathartic function ” that enables children to express feelings , release tension and understand their feelings and concerns . 4 They state that play is a “ pivotal element ” that allows them to become active in their health care and lives . More benefits of play for children with medical challenges include :
• Supporting intellectual , emotional and social development .
• Providing space for relaxation , distraction and socialization .
• Offering time for self-expression and communication with family and care team .
• Providing an outlet to express emotion and explore possibilities .
• Providing opportunities for control , ownership and understanding of their situation .
• Reducing negative emotional manifestations .
• Decreasing the need for nonpharmacological interventions .
22 LOUISVILLE MEDICINE