Establishing Telemedicine in an Academic Total Joint Arthroplasty Practice: Needs and Opportunities Highlighted by the COVID-19 Pandemic

Rao, Sandesh S.; Loeb, Alexander E.; Amin, Raj M.; Golladay, Gregory J.; Levin, Adam S.; Thakkar, Savyasachi C.

doi:10.1016/j.artd.2020.04.014

Cited by 67 publications

(94 citation statements)

References 46 publications

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“…Outpatients can adopt either asynchronous (not same time using e-mail, patient portal messages, health apps, e-consults, etc.) [2,22,23] or synchronous (same time using telephone, videoconferencing, etc.) telemedicine and virtual software platforms [10,11,18].…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, adoption of telemedicine and virtual software platforms might be challenging for some citizens as they will need training in adopting digital technologies [11,20]. Findings from prior studies [18] suggest that unfamiliarity with virtual software platforms is a key barrier to adoption of telemedicine services [2,5,23].…”

Section: Organizational Factorsmentioning

confidence: 99%

“…On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak as a pandemic, with more than 720,000 cases reported over 203 countries as of March 31, 2020. The novel COVID-19 pandemic has altered our society, economy, and healthcare system [1,2]. Residents were advised to quarantine themselves, and countries have closed their doors to visitors to protect their citizens [3].…”

Section: Introductionmentioning

confidence: 99%

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Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic

2020

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As the novel coronavirus disease 2019 (COVID-19) continues to spread across countries, the need for innovative measures to provide high-quality patient care and manage its spread has become more imperative. Software-based systems such as medical software applications could provide valuable suggestion on health-related information to physicians towards improving quality of life, especially for outpatients (e.g., elderly, immunosuppressed, pregnant women). The use of telemedicine and virtual software offers promising potential in the fight against COVID-19. Accordingly, by means of expedited literature and document review, this paper provides implication on the opportunities, application, and challenges of telemedicine and existing virtual software currently adopted as suitable initiatives for reducing the spread of COVID-19. More importantly, findings present factors that impact adoption of telemedicine. The findings suggest that telemedicine and virtual software are capable of decreasing emergency room visits, safeguarding healthcare resources, and lessening the spread of COVID-19 by remotely treating patients during and after the COVID-19 pandemic.

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Section: Resultsmentioning

confidence: 99%

Section: Organizational Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic

2020

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“…The COVID-19 crisis has resulted in a sudden and dramatic shift in the delivery of clinical care for patients with sports medicine injuries, away from in-person outpatient clinic visits to remote telehealth evaluations. 48,62 Web-based videoconferencing platforms are widely available, are user-friendly, and enable face-to-face patient-clinician interaction. 23 As a consequence of social distancing measures and imposed restrictions on in-person evaluations, clinicians and patients have been forced to embrace videoconferencing regardless of their previous notions.…”

mentioning

confidence: 99%

“…38 However, we now recognize that telehealth is an effective option for musculoskeletal care and will likely endure even after the pandemic, driven by physician and patient demand for efficiency and convenience. 38,44,48,62 One common stance was that musculoskeletal telehealth visits are limited without an in-person physical examination. 9,28,29,66,67 Although 1 recently published study described basic physical examination components, 62 to our knowledge, we provide below the first comprehensive description of a shoulder and knee physical examination for telehealth purposes.…”

mentioning

confidence: 99%

The Virtual Shoulder and Knee Physical Examination

Lamplot

Pinnamaneni

Swensen-Buza

et al. 2020

Orthopaedic Journal of Sports Medicine

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The COVID-19 crisis has forced a sudden and dramatic shift in the way that clinicians interact with their patients, from outpatient encounters to telehealth visits utilizing a variety of internet-based videoconferencing applications. Although many aspects of pre–COVID-19 outpatient sports medicine care will ultimately resume, it is likely that telehealth will persist because of its practicality and because of patient demand for access to efficient and convenient health care. Physical examination is widely considered a critical obstacle to a thorough evaluation of sports medicine patients during telehealth visits. However, a closer reflection suggests that a majority of the examination maneuvers are possible virtually with limited, if any, modifications. Thus, we provide a comprehensive shoulder and knee physical examination for sports medicine telehealth visits, including (1) verbal instructions in layman’s terms that can be provided to the patient before or read verbatim during the visit, (2) multimedia options (narrated videos and annotated presentations) of the shoulder and knee examination that can be provided to patients via screen-share options, and (3) a corresponding checklist to aid in documentation.

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Telemedicine visits generate accurate surgical plans across orthopaedic subspecialties

Crawford

Lightsey

Xiong

et al. 2021

Arch Orthop Trauma Surg

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Introduction The role of telemedicine is rapidly evolving across medical specialties and orthopaedics. The utility of telemedicine to identify operative candidates and determine surgical plans has yet to be demonstrated. We sought to assess whether surgical plans proposed following telemedicine visits changed after subsequent in-person interaction across orthopaedic subspecialties. Materials and methods We identified all elective telemedicine encounters across two academic institutions from March 1, 2020 to July 31, 2020. We identified patients indicated for surgery with a specific surgical plan during the virtual visit. The surgical plans delineated during the telemedicine encounter were then compared to final pre-operative plans documented following subsequent in-person evaluation. Changes in the surgical plan between telemedicine and in-person encounters were defined using a standardised schema. Regression analysis was used to evaluate factors associated with a change in surgical plan between visits across specialties, including the number of virtual examination manoeuvres performed. Results We identified 303 instances of a patient being indicated for orthopaedic surgery during a telemedicine encounter. In 11 cases (4%), the plan was changed between telemedicine and subsequent in-person encounter. No plans were changed amongst patients indicated for joint arthroplasty and foot and ankle surgery, whilst 4% of plans were changed amongst sports surgery and upper extremity/shoulder surgery. Surgical plans had the highest rate of change amongst spine surgery patients (8%). There was notable variability in the conduct of virtual examinations across subspecialties. Conclusion Our results demonstrate the capability of telemedicine to support development of accurate surgical plans for orthopaedic patients across several subspecialties. Our findings also highlight the substantial variation in the utilisation of physical examination manoeuvres conducted via telemedicine across institutions, subspecialties, and providers. Description of study type Level IV, retrospective cohort study.

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Establishing Telemedicine in an Academic Total Joint Arthroplasty Practice: Needs and Opportunities Highlighted by the COVID-19 Pandemic

Cited by 67 publications

References 46 publications

Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic

Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic

The Virtual Shoulder and Knee Physical Examination

Telemedicine visits generate accurate surgical plans across orthopaedic subspecialties

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