Abstract: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 simi… Show more
“…New technologies that have emerged, such as virtual goniometers, wearable sensors (wristbands) and app-based patient questionnaires, have improved clinicians’ abilities to conduct telehealth visits [ 38 ]. Digital technology platforms provide a scalable, meaningful approach to engaging patients throughout the continuum of joint replacement care and may serve as a cost-effective adjunct to traditional methods [ 39 ].…”
Section: Resultsmentioning
confidence: 99%
“…Some challenges still exist, including adaptation of new technologies and widespread accessibility, 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 [ 38 ]. There is sufficient evidence to recommend the use of telemedical methods in orthopedics [ 42 ].…”
The importance of telemedicine technologies around the world has been growing for many years, and it turned out to be a particularly important issue for conducting some medical procedures during the SARS-CoV-2 pandemic. It is necessary to create interdisciplinary teams to design and implement improved procedures using telemedicine tools. The aim of the article is to develop original, improved posthospital patient care process after total hip arthroplasty (THA) with the use of telemedicine technologies. In the study, a literature review and empirical research were used. The conducted research resulted in the designing an original posthospital patient care process after THA that uses telematics technologies. Due to the use of analyzed telemedicine technologies, the designed patient care process brings a possibility to increase the patient′s safety by monitoring life parameters, allowing for regular, remote contact with specialists and to be supervised remotely. All this may contribute to shortening the convalescence time, reducing the risk of complications, as well as reducing treatment costs. The designed model is ready for further clinical research with the participation of medical staff, patients after THA and patient caregivers.
“…New technologies that have emerged, such as virtual goniometers, wearable sensors (wristbands) and app-based patient questionnaires, have improved clinicians’ abilities to conduct telehealth visits [ 38 ]. Digital technology platforms provide a scalable, meaningful approach to engaging patients throughout the continuum of joint replacement care and may serve as a cost-effective adjunct to traditional methods [ 39 ].…”
Section: Resultsmentioning
confidence: 99%
“…Some challenges still exist, including adaptation of new technologies and widespread accessibility, 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 [ 38 ]. There is sufficient evidence to recommend the use of telemedical methods in orthopedics [ 42 ].…”
The importance of telemedicine technologies around the world has been growing for many years, and it turned out to be a particularly important issue for conducting some medical procedures during the SARS-CoV-2 pandemic. It is necessary to create interdisciplinary teams to design and implement improved procedures using telemedicine tools. The aim of the article is to develop original, improved posthospital patient care process after total hip arthroplasty (THA) with the use of telemedicine technologies. In the study, a literature review and empirical research were used. The conducted research resulted in the designing an original posthospital patient care process after THA that uses telematics technologies. Due to the use of analyzed telemedicine technologies, the designed patient care process brings a possibility to increase the patient′s safety by monitoring life parameters, allowing for regular, remote contact with specialists and to be supervised remotely. All this may contribute to shortening the convalescence time, reducing the risk of complications, as well as reducing treatment costs. The designed model is ready for further clinical research with the participation of medical staff, patients after THA and patient caregivers.
“…In consideration of the fact that there is already some evidence for the acceptance and effectiveness of video-based and phone counseling formats (10,13,22,23,27), this exploratory study was able to show that especially in psychosomatic counseling, videotelephonic counseling can represent an essential and effective support function. As possible limitations, it should be noted that the present study was based on a single time point exploratory online survey in psychosomatic patients without follow up and without healthy control group.…”
Section: Discussionmentioning
confidence: 93%
“…It can be assumed here that in middle to increasing age, technical hurdles and complications could lead to feelings of being overwhelmed and to impairment of the consultation/therapy conversation. Prior research also suggested that with increasing age the tolerance level regarding technical hurdles or complications decreases and consequently the video contact cannot be fully utilized and may be perceived as unsatisfactory (27). However, despite potential difficulties and technical hurdles, regular use and greater support could reduce technical hurdles (3,28).…”
Background: Due to the COVID-19 pandemic, the healthcare system in general and psychosomatics in particular were forced to change counseling-specific services and break up established structures. At the beginning of 2020, phone as well as videotelephonic counseling options had to be quickly established.Methods: Patients (n = 278) of the department of psychosomatic medicine and psychotherapy at the University Hospital Tübingen were asked to complete an ad hoc questionnaire to assess the acceptance of the counseling format following each counseling session (office, phone, video) in the period between July 2020 and February 2021.Results: Satisfaction and acceptance of the three counseling formats (office, phone, video) were rated (1–6) on average as “good” to “very good” in the three subgroups (1.5 ± 0.9). Likewise, the “therapeutic relationship” scored high in all three subgroups in terms of establishing a strong therapeutic relationship (4.4 ± 1.5). “Hurdles” were rated as low and tolerable (1.8 ± 1.3). The global assessment of therapeutic contact was significantly better in the video group compared to phone and office consultation (p < 0.05). Predictor analyses showed that there was an influence of age, but not gender, on the acceptance of digital counseling formats in the present sample [F(1, 277) = 4.50, p = 0.04].Discussion & Conclusion: Digital consultation formats were perceived by patients as promising addition to the classic face-to-face setting. Digital formats (phone, video) were not generally preferred to face-to-face counseling, but especially video counseling was accepted and perceived with great satisfaction and acceptance. Accordingly, the additional use of digital counseling formats, especially video-telephony, could be an opportunity to enrich the existing structures also after the pandemic.
“…Within orthopaedic surgery, total joint arthroplasty (TJA) providers were early adopters of telehealth [ 5 , 6 , 7 ]. Although increased utilization of telehealth was evident in the first several months of the COVID-19 pandemic, it is not known if this represents a lasting or transient care delivery model in arthroplasty [ 7 ].…”
Background
The Coronavirus Disease 2019 (COVID-19) pandemic has led to an increase in telehealth utilization across healthcare. It is unknown if telehealth use among hip and knee arthroplasty clinics has remained an important healthcare delivery platform. The purpose of the present study was to analyze telehealth utilization prior to and for one-year during the pandemic among four, varied hip and knee arthroplasty clinics.
Methods
Retrospective data was available from four, regionally diverse hip and knee arthroplasty centers. Data on volume of patient visits, demographics, visit types (new visit, follow-up, postoperative visit, other), visit modality (in-person, telehealth, telephone) was available from January 2020 through April 2021. Data from the centers was analyzed as a total and separately, using Chi-squared and Fisher exact tests.
Results
Among the four centers, there were 296,540 hip and knee arthroplasty outpatient clinic visits between January 2020 through April 2021. Of those, 15,240 (5%) were telehealth visits. Prior to March 2020, less than 0.1% of visits across centers occurred over telehealth. The highest utilization of telehealth visits occurred in March 2020 (>55%) and April 2020 (>25%). From August 2020 until April 2021, telehealth visits accounted for 2-3% of total visits. Younger patients (<50 years old) were most likely to utilize telehealth. Follow-up and postoperative were the most likely telehealth visits.
Conclusion
Telehealth utilization peaked during March and April of 2020 and has since reverted to near pre-pandemic levels. Younger patients and lower complexity visits such as postoperative or follow-up visits are more likely to utilize telehealth.
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