Adoption of Telemedicine: A Debrief for the Orthopedic Practitioner

Samartzis

et al. 2022

Self Cite

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Appropriate Telemedicine Utilization in Spine Surgery

Iyer

Samartzis

et al. 2022

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“…4 Due to these positive findings, recent studies have aimed to provide specific guidelines and a framework to allow for a more comprehensive spine patient evaluation, particularly focusing on the telemedicine physical examination. [5][6][7][8][9] While these guidelines and framework have certainly helped surgeons substitute portions of a typical in-person physical examination, their ability to provide accurate diagnoses and ultimately surgical plans have not been validated. Data on whether or not a telemedicine visit alone is sufficient to indicate a patient for spine surgery is lacking and heavily debated.…”

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confidence: 99%

“…In a recent study, 95% of spine patients seen via telemedicine were “satisfied” or “very satisfied” with their telemedicine visit, with 62% stating it was “the same” or “better” than previous in-person appointments 4. Due to these positive findings, recent studies have aimed to provide specific guidelines and a framework to allow for a more comprehensive spine patient evaluation, particularly focusing on the telemedicine physical examination 5–9…”

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confidence: 99%

Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients

Song

Kim

et al. 2022

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Study Design. A Retrospective cohort study. Objective. To (1) assess whether diagnoses and surgical plans established during a new patient telemedicine visit changed following an in-person evaluation and (2) determine any differences in perioperative outcomes between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. Summary of Background Data. Data on capability of telemedicine to deliver high-quality preoperative assessment without a traditional in-person interaction and physical examination is lacking. Materials and Methods. Records of patients who had a new patient telemedicine visit and indicated for surgery with documented specific diagnosis as well as surgical plans from a spine department at an urban tertiary center from April 2020 to April 2021 were reviewed. For a subset of patients that had a follow-up in-person evaluation before surgery, these diagnoses and plans were compared. Perioperative outcomes were compared between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. Results. A total of 166 patients were included. Of these, 101 patients (61%) only had a new patient telemedicine visit before surgery while 65 (39%) had a telemedicine visit followed by an inperson evaluation. There were no differences in the rate of case cancellations before surgery and patient-reported outcome measures between these two groups (P > 0.05). Of 65 patients who had both a telemedicine followed by an in-person visit, the diagnosis was unchanged for 61 patients (94%) and the surgical plan did not change for 52 patients (80%). The main reason for surgical plan change was due to updated findings on new imaging, 10 patients, (77%). Conclusions. The current study suggests that telemedicine evaluations can provide an effective means of preoperative assessment for spine patients.

“…2,4,6,7 Since that time, telemedicine delivery has continued to grow, with provider familiarity with technology, improved physical examination guidelines, and technological infrastructure. 10,12,16,17,20 Altogether, high patient satisfaction rates with telemedicine, even after the initial peak pandemic lockdown period and increased patient comfort with in-person office visits, suggests that telemedicine has a lasting future in spine surgery.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine in Spine Patients

Chen

Song

et al. 2023

Self Cite

Study Design. Retrospective cohort study.Objective. The objectives of the present study were to (1) define telemedicine utilization rates during and after the initial height of the COVID-19 lockdown period and (2) determine patient satisfaction with telemedicine during and after the initial height of the COVID-19 lockdown period for spine patients at an orthopedic specialty hospital. Summary of Background Data. Previous studies have shown high patient satisfaction with telemedicine during the initial height of the COVID-19 pandemic. However, there exists limited data about spine telemedicine utilization and patient satisfaction after the reopening of in-person office visits and the easing of restrictions on elective surgical care. Materials And Methods. All patients who had an in-person or telemedicine visit at an urban tertiary specialty hospital from April 1, 2020 to April 15, 2021 were identified. Rates of overall telemedicine utilization over time were delineated. Patient satisfaction with telemedicine, as assessed through a series of questionnaires, was also evaluated over time. Results. Overall, 60,368 patients were identified. Of these, 19,568 patients (32.4%) had telemedicine visit. During the peak initial coronavirus lockdown period, the rate of overall telemedicine utilization, on average, was greater than 90%. After the peak period, the rate of overall telemedicine utilization on average was at ~29% of all visits per month. The percentage of patients who would have been definitely comfortable if the telemedicine visit had been in-person increased over the entire study period (P < 0.001). Despite this, patient satisfaction based on survey responses remained statistically similar throughout the study period (P > 0.05). Conclusion. The rate of telemedicine utilization in spine patients remains high, at ~one-third of all visits, even after the initial peak coronavirus lockdown period. In addition, patient satisfaction with telemedicine remained consistent throughout the study period, regardless of pandemic restrictions on in-person visits.