Establishing a Telemedicine Program for Breast Reconstruction

Abstract

Summary: Telemedicine is an application of modern technology that allows for the remote delivery of healthcare services to diagnose and treat patients. The potential patient benefits of such a program include added convenience, lowered costs, and improved access. From a practical standpoint, establishing a telemedicine program may seem daunting to the plastic surgeon; success requires not only patient and provider adoption, but also integration of new technology. Despite these challenges, breast reconstruction patients are among those who stand to benefit most from telemedicine technology, as this patient population remains vulnerable to limitations to access following an emotion-provoking breast cancer diagnosis. Geographical limitation, especially in rural areas, represents a major barrier to access. To date, the application of telemedicine in caring for breast reconstruction patients has not been described in the literature. In this article, we describe the protocol developed and implemented by our academic plastic surgery group to care for new breast reconstruction candidates and discuss the role of telemedicine in improved access to breast reconstruction care.

Plastic Surgery in the Gulf Cooperation Council Countries: Role of Telemedicine

“… 10 Xue et al elaborated on their experience in applying telemedicine in breast reconstruction starting from patient selection to postoperative follow-up. 11 Our study highlights the integration of telemedicine during the COVID-19 pandemic among plastic surgeons practicing in the Gulf region; it shows that around 37.1% of the sample practiced telemedicine.…”

The Doctor Will “See” You Now – Unmet Expectations of Telemedicine in Plastic Surgery

“…20 Of these, Zoom and Doxy.me are HIPAA-compliant. 22,23 It is critical that plastic surgeons undergo appropriate training to familiarize themselves with a HIPAA compliant platform in order to provide patients with optimal care and privacy. 22 According to the American Society of Plastic Surgeons, 92% of all patients undergoing plastic surgery are female, yet the ratio of female to male plastic surgeons is 1:5.…”

“…22,23 It is critical that plastic surgeons undergo appropriate training to familiarize themselves with a HIPAA compliant platform in order to provide patients with optimal care and privacy. 22 According to the American Society of Plastic Surgeons, 92% of all patients undergoing plastic surgery are female, yet the ratio of female to male plastic surgeons is 1:5. 24,25 It is, therefore, recommended that a same-sex chaperone is present during a sensitive examination to ensure the patient's safety and comfort.…”

“…33 To avoid this, physicians should remind patients that they cannot perform tactile exams and cannot offer immediate feedback, leading to the possibility of a change in treatment plan after an in-person visit. 22 Moreover, the top barriers of telemedicine among patients are poor digital health literacy and lack of equipment. 34 Some patients, who are unfamiliar with telemedicine and lack the health education to use these platforms effectively, may be left with little guidance.…”

Plastic Surgeons Nationwide Share Experience Regarding Telemedicine in Initial Patient Screening and Routine Postoperative Visits

“…Rural areas use telemedicine for patient evaluation and postoperative monitoring. 2 From a surgical perspective, previous studies demonstrate that live-streaming procedures could be an educational tool for surgeons. After watching these live procedures, the surgeons’ self-reported confidence in their ability to operate increased.…”