• Susan Shenoi, Kristen Hayward, Megan L Curran, Elizabeth Kessler, Jay J Mehta, Meredith P Riebschleger, and Helen E Foster.
• Department of Pediatrics, Division of Rheumatology, Seattle Children's Hospital and Research Center, University of WA, MA.7.110 4800 Sand Point Way NE, Seattle, WA, 98105, USA. Susan.shenoi@seattlechildrens.org.
• Pediatr Rheumatol. 2020 Oct 31; 18 (1): 85.

BackgroundThe use of telemedicine in pediatric rheumatology has been historically low. The current COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting virtual visits to conduct care resulting in rapid expansion of use of telemedicine amongst practices. BODY: This commentary discusses practical tips for physicians including guidance around administrative and governance issues, preparation for telemedicine, involving the multidisciplinary care team, and teaching considerations. We also outline a standard proforma and smart phrases for the electronic health record. A proposed variation of the validated pediatric gait arms legs spine examination (pGALS) called the video pGALS (VpGALS) as a means of conducting virtual pediatric rheumatology physical examination is presented.ConclusionThis commentary provides a starting framework for telemedicine use in pediatric rheumatology and further work on validation and acceptability is needed.

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