Development of a Telemedicine Neurological Examination for Spine Surgery

Goyal, Dhruv K.C.; Divi, Srikanth N.; Schroeder, Gregory D.; Pfeifer, Ryan; Canseco, José A.; Bowles, Daniel R; Nicholson, Kristen; Patel, Parthik D.; Reyes, Ariana A; Radcliff, Kris; Kurd, Mark F.; Woods, Barrett I.; Kaye, I. David; Rihn, Jeffrey A.; Anderson, D. Greg; Hilibrand, Alan S.; Kepler, Christopher K.; Harrop, James S.; Vaccaro, Alexander R.

doi:10.1097/bsd.0000000000001066

Cited by 33 publications

(28 citation statements)

References 51 publications

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“…Advocates of telemedicine describe widespread benefits that include: increased access to care, high clinician/ patient satisfaction rates, and overall cost savings [7][8][9]. Opponents, on the other hand, are concerned about greater medicolegal exposure, decreased ability to perform physical examinations, and weaker doctor-patient relationships, thus highlighting the importance of in-person visits [10].…”

Section: Introductionmentioning

confidence: 99%

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

et al. 2021

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Introduction While telemedicine usage has increased due to the COVID-19 pandemic, there remains little consensus about how spine surgeons perceive virtual care. The purpose of this study was to explore international perspectives of spine providers on the challenges and benefits of telemedicine. Methods Responses from 485 members of AO Spine were analyzed, covering provider perceptions of the challenges and benefits of telemedicine. All questions were optional, and blank responses were excluded from analysis. Results The leading challenges reported by surgeons were decreased ability to perform physical examinations (38.6%), possible increased medicolegal exposure (19.3%), and lack of reimbursement parity compared to traditional visits (15.5%). Fewer than 9.0% of respondents experienced technological issues. On average, respondents agreed that telemedicine increases access to care for rural/long-distance patients, provides societal cost savings, and increases patient convenience. Responses were mixed about whether telemedicine leads to greater patient satisfaction. North Americans experienced the most challenges, but also thought telemedicine carried the most benefits, whereas Africans reported the fewest challenges and benefits. Age did not affect responses. Conclusion Spine surgeons are supportive of the benefits of telemedicine, and only a small minority experienced technical issues. The decreased ability to perform the physical examination was the top challenge and remains a major obstacle to virtual care for spine surgeons around the world, although interestingly, 61.4% of providers did not acknowledge this to be a major challenge. Significant groundwork in optimizing remote physical examination maneuvers and achieving legal and reimbursement clarity is necessary for widespread implementation.

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Section: Introductionmentioning

confidence: 99%

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

et al. 2021

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“…5,6 Telemedicine has been used in almost every specialty, including procedural specialties. 5,[7][8][9][10][11][12][13][14][15][16][17] Further, especially since the beginning of the COVID-19 pandemic, telemedicine use has increased internationally. [18][19][20][21] Although various forms of telemedicine, including phone calls and electronic messaging, have been used extensively in our clinic for years, the COVID-19 pandemic has led to the implementation and successful use of audiovisual technologies for patient care visits across the Mayo Clinic enterprise.…”

mentioning

confidence: 99%

Physician Satisfaction With Telemedicine During the COVID-19 Pandemic: The Mayo Clinic Florida Experience

Malouff¹,

TerKonda²,

Knight³

et al. 2021

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Objective To evaluate physician perceptions and attitudes toward telemedicine use at a tertiary care academic institution in Northeast Florida during the COVID-19 pandemic. Methods An anonymous 38-question cross-sectional survey was developed using Qualtrics and emailed to all staff physicians from all specialty disciplines at the Mayo Clinic Florida. The survey was open from August 17, 2020 through September 1, 2020. Collected data included general demographics and employment information, attitude and experience with telemedicine use before and during COVID-19, perception of patients’ experience, and the effect of telemedicine on burnout. Results The survey was distributed to 529 eligible physicians at our institution, with 103 physicians responding (19.5%). The distribution of specialties was 22.3% primary care specialties, 40.8% other internal medicine subspecialties, and 17.5% surgical specialties. Collectively, 63% found comparable quality of care when provided virtually (vs. in-person), while 80% perceived telemedicine as cost-effective. A total of 76% of physicians felt that telemedicine increased flexibility and control over patient-care activities, with 36% reporting improved work-life balance and 30% reporting improved burnout symptoms. Overall, 42% preferred using telemedicine over in-person visits when possible. Conclusions Physicians generally held positive attitudes regarding the adoption of telemedicine, and perceived that the quality of healthcare delivery as generally comparable to in-person care. Future studies are needed to explore attitudes regarding telemedicine after the pandemic, and how this virtual technology may be further utilized to improve physicians’ professional and personal well-being.

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“…Goyal et al. 66 recognised that assessment of motor, sensory, and special tests performed with telemedicine had similar observations to the traditional in-person examination. However, the authors stressed that the assessment needs to be administered by an experienced clinician.…”

Section: Discussionmentioning

confidence: 92%

“…Fifty-nine articles met the inclusion criteria and were considered for the analysis. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 The excluded thirty-four papers were editorials, letters, duplicate entries, and articles with no discussion on telemedicine even in the full text ( Figure 1 ). The monthly contributions trend of the orthopaedic telemedicine-related articles is shown in Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

Telemedicine trends in orthopaedics and trauma during the COVID-19 pandemic: A bibliometric analysis and review

Kumar

Sinha

Jameel

et al. 2022

Journal of Taibah University Medical Sciences

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Objectives In the wake of recent widespread interest in telemedicine during the COVID-19 era, many orthopaedic surgeons may be unfamiliar with clinical examination skills, patients’ safety, data security, and implementation-related concerns in telemedicine. We present a bibliometric analysis and review of the telemedicine-related publications concerning orthopaedics care during the COVID-19 pandemic. Such analysis can help orthopaedic surgeons become acquainted with the recent developments in telemedicine and its usage in regular orthopaedics practice. Methods We systematically searched the database of Thomson Reuters Web of Science for telemedicine-related articles in orthopaedics published during the COVID-19 pandemic. The selected articles were analysed for their source journals, corresponding authors, investigating institutions, countries of the corresponding authors, number of citations, study types, levels of evidence, and qualitative review. Results Fifty-nine articles meeting the inclusion criteria were published in 28 journals. Three hundred forty-two authors contributed to these research papers. The United States (US) contributed the most number of articles to the telemedicine-related orthopaedics research during the COVID-19 era. All articles combined had a total of 383 citations and 66.1% were related to the Economic and Decision-making Analyses of telemedicine implementation. By and large, level IV evidence was predominant in our review. Conclusion Telemedicine can satisfactorily cover a major proportion of patients' visits to outpatient departments, thus limiting hospitals’ physical workload. Telemedicine has a potential future role in emergency orthopaedics and inpatient care through virtual aids. The issues related to patient privacy, data security, medicolegal, and reimbursement-related aspects need to be addressed through precise national or regional guidelines. Lastly, the orthopaedic physical examination is a weak link in telemedicine and needs to be strengthened.

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Development of a Telemedicine Neurological Examination for Spine Surgery

Cited by 33 publications

References 51 publications

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

Physician Satisfaction With Telemedicine During the COVID-19 Pandemic: The Mayo Clinic Florida Experience

Telemedicine trends in orthopaedics and trauma during the COVID-19 pandemic: A bibliometric analysis and review

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