Barriers associated with failed completion of an acute care general surgery telehealth clinic visit

Kemp, Michael T.; Williams, Aaron M.; Sharma, Sriganesh B.; Biesterveld, Ben E.; Wakam, Glenn K.; Matusko, Niki; Wilson, Jesse K.; Cohen, Mark S.; Alam, Hasan B.

doi:10.1016/j.surg.2020.06.029

Cited by 21 publications

(45 citation statements)

References 19 publications

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“…Twenty-one studies were based in the USA [ 31 – 51 ], three in Australia [ 52 – 54 ], two in Canada [ 55 , 56 ], and one each in Chile [ 57 ], Italy [ 58 ] and Scotland [ 59 ]. One based their research in primary and secondary care settings [ 37 ], one in primary and tertiary care [ 44 ], eleven solely in secondary care [ 39 , 41 , 45 , 46 , 51 , 52 , 55 – 59 ] and sixteen in tertiary care [ 31 – 36 , 38 , 40 , 42 , 43 , 47 – 50 , 53 , 54 ]. The research was specifically set in the context of COVID-19 in twenty-one studies [ 32 , 33 , 35 – 39 , 41 , 43 – 51 , 54 , 56 – 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…The research was specifically set in the context of COVID-19 in twenty-one studies [ 32 , 33 , 35 – 39 , 41 , 43 – 51 , 54 , 56 – 58 ]. Four studies reported on the number of participants offered a remote consultation [ 32 , 42 , 43 , 52 ], two reported the number of patients who declined a remote consultation [ 42 , 43 ] and three assessed the number of patients who failed to attend their appointment [ 40 , 52 , 59 ]. Only one study reported separate recruitment numbers for new and established patients [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…All but one study reported data on participants’ gender [ 49 ], with twenty reporting ethnicity data [ 31 – 33 , 35 – 42 , 44 – 46 , 48 – 51 , 53 , 55 ] and fifteen mean age [ 31 – 35 , 39 , 42 , 46 , 48 , 51 – 54 , 57 , 58 ] ( Table 2 ). Twenty one studies reported data from a single time period [ 31 – 34 , 36 , 37 , 39 , 40 , 42 – 44 , 47 , 49 , 52 – 59 ], and eight reported a comparison of remote consultation uptake rates across two time periods [ 35 , 38 , 41 , 45 , 46 , 48 , 50 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-eight studies reported uptake of video consultations, with uptake rates ranging from 5% [ 31 ] to 78% [ 40 ]. Eight studies reported on the uptake of telephone consultations ranging from 12% [ 36 ] to 78%…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Real-time remote outpatient consultations in secondary and tertiary care: A systematic review of inequalities in invitation and uptake

Jones

Damery²,

Phillips³

et al. 2022

PLoS ONE

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Background Health policies in most high income countries increasingly recommend provision of routine outpatient care via remote (video and/or telephone) appointments, especially due to the pandemic. This is thought to improve access to care and promote efficiency within resource-constrained health services. There is limited evidence about the impact on existing inequalities in the invitation and uptake of health services when remote outpatient care is offered. Aim To systematically review the evidence on the offer and/or uptake of real-time remote outpatient consultations in secondary and tertiary care, assessed according to key sociodemographic characteristics. Methods Seven electronic bibliographic databases were searched for studies reporting the proportion of patients with key characteristics (following PROGRESS Plus criteria) who were offered and/or accepted real-time remote outpatient consultation for any chronic condition. Comparison groups included usual care (face-to-face), another intervention, or offer/uptake within a comparable time period. Study processes were undertaken in duplicate. Data are reported narratively. Results Twenty-nine studies were included. Uptake of video consultations ranged from 5% to 78% and telephone consultations from 12% to 78%. Patients aged over 65, with lower educational attainment, on lower household incomes and without English as a first language were least likely to have a remote consultation. Females were generally more likely to have remote consultations than males. Non-white ethnicities were less likely to use remote consultations but where they did, were significantly more likely to choose telephone over video appointments (p<0.001). Conclusions Offering remote consultations may perpetuate or exacerbate existing health inequalities in access to healthcare. More research is needed on current health disparities by sociodemographic characteristics and to explore what works well for different patient groups and why so that processes can be designed to ameliorate these health disparities. Trial registration PROSPERO registration no: CRD42021241791.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Real-time remote outpatient consultations in secondary and tertiary care: A systematic review of inequalities in invitation and uptake

Jones

Damery²,

Phillips³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Some patients had trouble connecting initially but were able to overcome their challenges with the guidance of our staff. Technical challenges are a documented barrier for telehealth services ( 36 ). We found that this challenge can be addressed with proper screening for access to technology and patient education prior the appointment.…”

Section: Discussionmentioning

confidence: 99%

Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

Brett¹,

Foster²,

Joseph³

et al. 2021

Journal of Patient Experience

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Patients with substance use disorder (SUD) rely upon urine drug testing to support treatment adherence and to mitigate relapse. Before the onset of coronavirus 2019 (COVID-19), the logistical challenges of randomized observed collections for urine drug testing for the patient were significant. During COVID-19, these barriers were often insurmountable. Since SUD patients represent a population at a higher risk for complications from COVID-19, an alternative strategy to support COVID-19 testing was urgently needed. We designed and deployed a telehealth-based solution in which patients could use mobile devices to connect with trained collection professionals to perform observed urine collections, often referred to a UA (urinalysis). The solution was designed with patient-centered best practices for telehealth, stigma prevention, trauma-informed, empathy and compassion, and to remove barriers to access to care. This approach demonstrated high patient satisfaction scores thereby proving that it is possible to provide urine collection services in the patient’s home via a telehealth technology, while still upholding SUD testing integrity best practices. This study lays the path for a more patient-centered way to support this population.

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Telemedicine-based new patient consultations for hernia repair and advanced abdominal wall reconstruction

Bray

Sutton

Akhter

et al. 2022

Hernia

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Purpose Telemedicine has emerged as a viable option to in-person visits for the evaluation and management of surgical patients. Increased integration of telemedicine has allowed for greater access to care for specific patient populations but relative outcomes are unstudied. Given these limitations, we sought to evaluate the efficacy of telemedicine-based new patient preoperative encounters in comparison to in-person encounters. Methods We performed a retrospective analysis of adult patients undergoing new patient evaluations from April 2020 to October 2021. Telemedicine visits consist of both video and telephone-based encounters. Visit types, patient demographics, preoperative diagnosis, travel time to the hospital, and prior imaging availability were reviewed. Results A total of 276 new patient encounters were conducted ( n = 108, 39% telemedicine). Indications for evaluation included inguinal hernia ( n = 81, 30%), ventral hernia ( n = 149, 54%) and groin or abdominal pain ( n = 30, 11%). Patients undergoing telehealth evaluations were more likely to have greater travel distance to the hospital (91 km vs 29 km, p = 0.002) and have CT image-confirmed diagnoses at the initial visit (73 vs 47%, p < 0.001). Patients who were evaluated for a recurrent or incisional hernia were more likely to be seen through a telemedicine encounter (69 vs 45%, p < 0.001). Conclusions We report the efficacy of telemedicine-based consultations for new patient preoperative evaluations related to hernia repair and abdominal wall reconstruction. Telemedicine is a useful modality for preoperative evaluation of new patients with hernia and advanced abdominal wall reconstruction needs. Understanding this patient population will allow us to optimize telemedicine encounters for new patients and improve access to care for patients in remote locations.

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Barriers associated with failed completion of an acute care general surgery telehealth clinic visit

Cited by 21 publications

References 19 publications

Real-time remote outpatient consultations in secondary and tertiary care: A systematic review of inequalities in invitation and uptake

Real-time remote outpatient consultations in secondary and tertiary care: A systematic review of inequalities in invitation and uptake

Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

Telemedicine-based new patient consultations for hernia repair and advanced abdominal wall reconstruction

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