0040 - Virtual Knee Arthroplasty Clinic; 5 Year Follow Up Data in a District General Hospital

Fisher, Richard D.; Khatun, Fariha; Reader, Sandie; Hamilton, Vida; Porteous, Matthew; Dunn, Andrew

doi:10.1016/j.knee.2017.08.036

Cited by 4 publications

(8 citation statements)

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“…Moreover, 86% of our VJRC patients reported they had experienced time and/or cost savings. This was in accordance with previous studies which reported that the use of virtual clinics resulted in reduction in travel time spent by the patients [15,20].…”

Section: Discussionsupporting

confidence: 93%

“…The VJRC response rate of 92% is higher than in other studies, with reported rates ranging from 76% to 83% [20,21]. A web-based follow-up study showed that 24% of their eligible patients declined to participate in the virtual follow-up due to lack of internet access.…”

Section: Discussionmentioning

confidence: 66%

“…Virtual follow-up clinics have been reported to be cost-effective compared to standard in-person follow-up [ 7 , 12 , 24 ], reducing the number of patients attending regular follow-up clinics, without compromising safe practice [ 20 ]. Kingsbury et al [ 7 ] estimated that an experienced orthopedic surgeon could review a questionnaire and a radiograph in 2 minutes whereas an outpatient appointment can take from 10 to 20 minutes.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness, Patient Satisfaction, and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty

Ashmawy

Dowson

El‐Bakoury

et al. 2021

The Journal of Arthroplasty

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Background Total hip and knee arthroplasties are increasingly performed operations, and routine follow-up places huge demands on orthopedic services. This study investigates the effectiveness, patients’ satisfaction, and cost reduction of Virtual Joint Replacement Clinic (VJRC) follow-up of total hip arthroplasty and total knee arthroplasty patients in a university hospital. VJRC is especially valuable when in-person appointments are not advised or feasible such as during the COVID-19 pandemic. Methods A total of 1749 patients who were invited for VJRC follow-up for knee or hip arthroplasty from January 2017 to December 2018 were included in this retrospective study. Patients were referred to VJRC after their 6-week postoperative review. Routine VJRC postoperative review was undertaken at 1 and 7 years and then 3-yearly thereafter. We evaluated the VJRC patient response rate, acceptability, and outcome. Patient satisfaction was measured in a subgroup of patients using a satisfaction survey. VJRC costs were calculated compared to face-to-face follow-up. Results The VJRC had a 92.05% overall response rate. Only 7.22% required further in-person appointments with only 3% being reviewed by an orthopedic consultant. VJRC resulted in an estimated saving of £42,644 per year at our institution. The patients’ satisfaction survey showed that 89.29% of the patients were either satisfied or very satisfied with VJRC follow-up. Conclusion VJRC follow-up for hip and knee arthroplasty patients is an effective alternative to in-person clinic assessment which is accepted by patients, has high patient satisfaction, and can reduce the cost to both health services and patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

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Effectiveness, Patient Satisfaction, and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty

Ashmawy

Dowson

El‐Bakoury

et al. 2021

The Journal of Arthroplasty

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“…2 To compare this internationally, however, this is lower than what was achieved in two recent UK studies, the first using a similar paper-based questionnaire with a response rate of 92.05%, 13,14 and the other being web-based with a response rate between 77% and 83%. 15 The 37 VC patients that were deemed uncontactable or lost to follow up appeared to refuse to re-engage with the hospital for ongoing review of their arthroplasty. Our administrative assistant ensures that patient contact details are absolutely correct as she will reach out to general practitioners and patients' nominated next-of-kin in order to verify these.…”

Section: Discussionmentioning

confidence: 99%

Virtual arthroplasty clinic: a single centre experience: commentary on progress, cost savings and patient retention

Lim

Calligeros

2022

ANZ Journal of Surgery

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Background:The COVID pandemic highlights utility of remote patient follow-up. We observe a Virtual Clinic (VC) follow-up model for arthroplasty used at a metropolitan hospital. Patients aged <70 that exhibit no issues in face-to-face review (F2F) progress to VC. We aimed to review VC's cost-effectiveness, and identify potential improvements to patient allocation and retention. Method: A retrospective database was collated of all hip and knee joint arthroplasties performed at Frankston Hospital over a 12-month period in 2017-2018. Patient encounters were followed from operation to discharge from F2F and, if appropriate, VC (involving imaging and a paper-based qualitative questionnaire). VC attendance was compared to that of the year in which it was introduced (2014). The Clinical Costings Department provided average hospital spending for each of these modes of follow-up. Results: Of 516 joint arthroplasties performed, 500 attended outpatient clinic (OPC). There were 884 F2F appointments (average 1.7 per person, range 0-12). One-hundred-and-fiftyfour arthroplasties were correctly assigned to subsequent VC as per protocol (30%). Completed VC responses were received for 86 arthroplasties (56% response rate). In the period studied, VC attendance increased significantly compared to the year following introduction (36-56%, p < 0.05), with the questionnaire revealing a high-level of patient satisfaction for this method of follow-up. Over the period studied, we estimate VC has saved $250 000 and 300 review hours from OPC. Conclusion: Implementing VC for follow-up of arthroplasty may demonstrate a method of saving hospital resources. Appropriate early enrolment of patients to reduce F2F burden, and VC retention, should be encouraged.

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“…Telemedicine has also been shown to be more efficient by reducing patient wait times and number of visits needed. One study showed that virtual follow-up after TKA that consisted of a patient questionnaire and x-rays at 5 yearly intervals avoided 1814 clinic appointments, which was equal to greater than 300 hours of clinic time without compromising patient safety [17]. El Ashmawy et al [16] found that 86% of patients undergoing virtual TJA consultation reported they had saved time and/or money, with 23% saying they saved travel time and 21% reporting less wait time.…”

Section: Benefits and Challenges Of Telehealth Servicesmentioning

confidence: 99%

An Overview of Telehealth in Total Joint Arthroplasty

et al. 2021

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With the increase in technological advances over the years, telehealth services in orthopedic surgery have gained in popularity, yet adoption among surgeons has been slow. With the onset of the COVID-19 pandemic, however, orthopedic surgery practices nationwide have accelerated adaptation to telemedicine. Telehealth can be effectively applied to total joint arthroplasty, with the ability to perform preoperative consultations, postoperative follow-up, and telerehabilitation in a virtual, remote manner with similar outcomes to in-person visits. New technologies that have emerged, such as virtual goniometers, wearable sensors, and app-based patient questionnaires, have improved clinicians’ ability to conduct telehealth visits. Benefits of using telehealth include high patient satisfaction, cost-savings, increased access to care, and more efficiency. Notably, some challenges still exist, including widespread accessibility and adaptation of new technologies, inability to conduct an in-person orthopedic physical examination, and regulatory barriers, such as insurance reimbursement, increased medicolegal risk, and privacy and confidentiality concerns. Despite these hurdles, telehealth is here to stay and can be successfully incorporated in any total joint arthroplasty practice with the appropriate adjustments.

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0040 - Virtual Knee Arthroplasty Clinic; 5 Year Follow Up Data in a District General Hospital

Cited by 4 publications

References 0 publications

Effectiveness, Patient Satisfaction, and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty

Effectiveness, Patient Satisfaction, and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty

Virtual arthroplasty clinic: a single centre experience: commentary on progress, cost savings and patient retention

An Overview of Telehealth in Total Joint Arthroplasty

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