Enhanced Telemedicine in Primary Care for Acute Respiratory Tract Infections Study

Young children often receive antibiotics for pediatric acute respiratory tract infections (ARTIs) - common childhood diagnoses like ear infections, strep throat, sinusitis, and colds - but many of these antibiotics are prescribed unnecessarily for viral infections, where antibiotics will not help. Helping families and pediatricians to evaluate children with ARTIs through primary care telemedicine visits using at-home tele-otoscopes vs. at-home eBooks could help reduce unnecessary antibiotic exposure in children. In this clinical trial, we will assess the impact of at-home tele-otoscope vs. eBook enabled primary care telemedicine on antibiotic use, healthcare utilization, and healthcare costs for young children.

Inclusion Criteria: * Child receives primary care at a participating study site * Child is between 6 months 0 days and 23 months 29 days * Child has one or more documented acute otitis media infections (diagnosed on the day of enrollment or previously) * Child presents with an adult who is the biological parent or legally authorized representative able to provide consent for the child's participation in the study. Exclusion Criteria: * Adult caregiver not able to participate in informed consent in English or Spanish * Child has congenital anomaly of face or ears * Child has history of myringotomy tube placement * Family lacks smart phone in household to pair with otoscope * Sibling or other child in same household already enrolled