Efficiency, Satisfaction, and Costs for Remote Video Visits Following Radical Prostatectomy: A Randomized Controlled Trial

Viers, Boyd R.; Lightner, Deborah J.; Rivera, Marcelino; Tollefson, Matthew K.; Boorjian, Stephen A.; Karnes, R. Jeffrey; Thompson, R. Houston; O’Neil, Daniel A.; Hamilton, Rachel L.; Gardner, Matthew R.; Bundrick, Mary; Jenkins, Sarah M.; Pruthi, Sandhya; Frank, Igor; Gettman, Matthew T.

doi:10.1016/j.eururo.2015.04.002

Cited by 214 publications

(224 citation statements)

References 26 publications

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“…99 There were no significant differences in patient perception of visit confidentiality, efficiency, education quality or overall satisfaction. Video visits incurred lower patient-borne costs and were associated with similar levels of urologist satisfaction to conventional outpatient visits.…”

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confidence: 93%

“…exploring issues of usability and acceptability). 45,[99][100][101][102][103][104][105][106][107][108][109][110][111][112][113] Many focus specifically on the clinical use of Skype, 91,[114][115][116][117][118][119][120][121][122][123] either on its own or in combination with other technologies [e.g. WhatsApp (WhatsApp Inc., Mountain View, CA, USA) messaging 124 or FaceTime 125,126 ].…”

Section: Evidence Relating To the Use Of Virtual Consultationsmentioning

confidence: 99%

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Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Shaw

Wherton

Vijayaraghavan

et al. 2018

Health Serv Deliv Res

141

170

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 13/59/26. The contractual start date was in March 2015. The final report began editorial review in July 2017 and was accepted for publication in November 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Depar...

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confidence: 93%

Section: Evidence Relating To the Use Of Virtual Consultationsmentioning

confidence: 99%

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Shaw

Wherton

Vijayaraghavan

et al. 2018

Health Serv Deliv Res

141

170

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“…[1][2][3] Telehealth in its many forms offers conveniences including increased care accessibility, decreased transportation barriers, and patient empowerment. [4][5][6][7][8] Studies of video visits have demonstrated these benefits in specialty settings including wound care, prenatal genetic screening, family planning, cardiovascular care, and home care. [9][10][11][12][13][14][15] One study of patient experiences with video visits in rural areas found that they were associated with decreased travel costs and lost time/wages, increased access to social support, and better ability to tailor care delivery to patient and family needs.…”

Section: Introductionmentioning

confidence: 99%

Patient Perceptions of Telehealth Primary Care Video Visits

et al. 2017

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PURPOSE Telehealth is a care delivery model that promises to increase the flexibility and reach of health services. Our objective is to describe patient experiences with video visits performed with their established primary care clinicians. METHODSWe constructed semistructured, in-depth qualitative interviews with adult patients following video visits with their primary care clinicians at a single academic medical center. Data were analyzed with a content analysis approach. RESULTS:Of 32 eligible patients, 19 were successfully interviewed. All patients reported overall satisfaction with video visits, with the majority interested in continuing to use video visits as an alternative to in-person visits. The primary benefits cited were convenience and decreased costs. Some patients felt more comfortable with video visits than office visits and expressed a preference for receiving future serious news via video visit, because they could be in their own supportive environment. Primary concerns with video visits were privacy, including the potential for work colleagues to overhear conversations, and questions about the ability of the clinician to perform an adequate physical examination.CONCLUSIONS Primary care video visits are acceptable in a variety of situations. Patients identified convenience, efficiency, communication, privacy, and comfort as domains that are potentially important to consider when assessing video visits vs in-person encounters. Future studies should explore which patients and conditions are best suited for video visits. INTRODUCTIONT elemedicine, or telehealth, includes telecommunication via a variety of platforms designed to enhance patient-centered health care.1-3 Telehealth in its many forms offers conveniences including increased care accessibility, decreased transportation barriers, and patient empowerment. [4][5][6][7][8] Studies of video visits have demonstrated these benefits in specialty settings including wound care, prenatal genetic screening, family planning, cardiovascular care, and home care. [9][10][11][12][13][14][15] One study of patient experiences with video visits in rural areas found that they were associated with decreased travel costs and lost time/wages, increased access to social support, and better ability to tailor care delivery to patient and family needs. 16Because of these benefits, video visits are being adopted in a variety of settings. Uptake in the United States has occurred most rapidly where reimbursement is favorable. Medicare reimburses for video visits in health professional shortage areas and for specific approved services.17 As a result, much knowledge about patient experiences with video visits is limited to specific disease-related applications and to use in rural settings. [18][19][20] Video visits are increasingly used in other settings, including primary care, but there are limited data on patient experiences with primary care video visits. One study tested video visits with patients communicating via webcam with their primary care physician w...

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“…Almost all previous research on video consultations in healthcare has either addressed the technical detail of the remote connection or undertaken a randomized controlled trial of virtual versus face-to-face consultations [13][14][15][16][17][18][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Such studies lend support to the conclusion that in selected patients, video consultations are non-inferior to face-to-face ones -but (often by their own admission) they leave unanswered the question of how to establish the service as a real-world option and/or move from a small-scale research or demonstration project to sustainable business-as-usual.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…Randomized controlled trials have shown such consultations to be acceptable, safe and effective (and, when measured, to reduce patient-borne costs) in patients deemed clinically eligible in a range of conditions including adult and teenage diabetes [16][17][18], chronic kidney disease [19], chronic obstructive pulmonary disease [20,21], mental health conditions [22,23], chronic pain [24][25][26], support after premature birth [27], support of patients in care homes [28], post-operative follow-up for orthopedics [29][30][31][32], plastic surgery [33] and prostate cancer [34].…”

Section: Introduction Backgroundmentioning

confidence: 99%

Real-World Implementation of Video Outpatient Consultations at Macro, Meso, and Micro Levels: Mixed-Method Study (Preprint)

Greenhalgh¹,

Shaw²,

Wherton³

et al. 2018

Preprint

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BACKGROUND There is much interest in virtual consultations using video technology. Randomized controlled trials have shown video consultations to be acceptable, safe, and effective in selected conditions and circumstances. However, this model has rarely been mainstreamed and sustained in real-world settings. OBJECTIVE The study sought to (1) define good practice and inform implementation of video outpatient consultations and (2) generate transferable knowledge about challenges to scaling up and routinizing this service model. METHODS A multilevel, mixed-method study of Skype video consultations (micro level) was embedded in an organizational case study (meso level), taking account of national context and wider influences (macro level). The study followed the introduction of video outpatient consultations in three clinical services (diabetes, diabetes antenatal, and cancer surgery) in a National Health Service trust (covering three hospitals) in London, United Kingdom. Data sources included 36 national-level stakeholders (exploratory and semistructured interviews), longitudinal organizational ethnography (300 hours of observations; 24 staff interviews), 30 videotaped remote consultations, 17 audiotaped face-to-face consultations, and national and local documents. Qualitative data, analyzed using sociotechnical change theories, addressed staff and patient experience and organizational and system drivers. Quantitative data, analyzed via descriptive statistics, included uptake of video consultations by staff and patients and microcategorization of different kinds of talk (using the Roter interaction analysis system). RESULTS When clinical, technical, and practical preconditions were met, video consultations appeared safe and were popular with some patients and staff. Compared with face-to-face consultations for similar conditions, video consultations were very slightly shorter, patients did slightly more talking, and both parties sometimes needed to make explicit things that typically remained implicit in a traditional encounter. Video consultations appeared to work better when the clinician and patient already knew and trusted each other. Some clinicians used Skype adaptively to respond to patient requests for ad hoc encounters in a way that appeared to strengthen supported self-management. The reality of establishing video outpatient services in a busy and financially stretched acute hospital setting proved more complex and time-consuming than originally anticipated. By the end of this study, between 2% and 22% of consultations were being undertaken remotely by participating clinicians. In the remainder, clinicians chose not to participate, or video consultations were considered impractical, technically unachievable, or clinically inadvisable. Technical challenges were typically minor but potentially prohibitive. CONCLUSIONS Video outpatient consultations appear safe, effective, and convenient for patients in situations where participating clinicians judge them clinically appropriate, but such situations are a fraction of the overall clinic workload. As with other technological innovations, some clinicians will adopt readily, whereas others will need incentives and support. There are complex challenges to embedding video consultation services within routine practice in organizations that are hesitant to change, especially in times of austerity.

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Efficiency, Satisfaction, and Costs for Remote Video Visits Following Radical Prostatectomy: A Randomized Controlled Trial

Cited by 214 publications

References 26 publications

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Patient Perceptions of Telehealth Primary Care Video Visits

Real-World Implementation of Video Outpatient Consultations at Macro, Meso, and Micro Levels: Mixed-Method Study (Preprint)

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