Evaluation of Telemedicine Use for Anesthesiology Pain Division: Retrospective, Observational Case Series Study

Jalilian, Laleh; Wu, Irene; Ing, Jakun; Dong, Xuezhi; Sadik, Joshua; Pan, George; Hitson, Heather; Thomas, Erin; Grogan, Tristan; Simkovic, Michael; Kamdar, Nirav

doi:10.2196/33926

Cited by 4 publications

(10 citation statements)

References 34 publications

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“…This could be attributed to multiple factors, which have been mentioned in previous publications, including the convenience of receiving care from the comfort of one’s home and the elimination of travel and wait time. 16 , 21 , 22 This is further supported when looking at the results from the regression analysis ( Table 4 ), demonstrating a significant association between residing outside of Manhattan and the utilization of telemedicine. In contrast, patients residing in Manhattan – in proximity to the locations examined in the study, but also an area well served by public transportation - preferred in-office visits post-lockdown.…”

Section: Discussionsupporting

confidence: 57%

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Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice

Rockholt,

Addae,

Chee

et al. 2023

JPR

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Purpose The COVID-19 pandemic led to a drastic expansion in utilizing telemedicine, circumventing some of the geographical barriers to accessing pain care. However, uncertainties around the impact of telemedicine across various sociodemographic groups still exist, prompting further exploration. Therefore, this study aimed to evaluate the impact of sociodemographic factors in telemedicine utilization during and after the COVID-19 pandemic. Patients and methods All outpatient non-procedural visits at the pain medicine division of a large academic institution in the epicenter of the pandemic (New York, USA), between March 2019 and October 2021, were retrospectively included. Sociodemographic data including gender, age, ethnicity/race, postal code, and type of health insurance, across three time periods associated with the COVID-19 pandemic - pre-lockdown (in-office visits only), lockdown (telemedicine visits only) and post-lockdown (offering both in-office and telemedicine visits) – were analyzed and compared. Results In total, 12,615 unique patients - The majority being women (58%) - were seen during the whole study period. In the post-lockdown period, telemedicine was utilized by 42% of all patients. Follow-up visits, younger patients, white patients, patients residing further away from the hospital, and privately insured patients were more likely to utilize telemedicine post-lockdown (p <0.05). Older patients, minorities, Manhattan residents, and Medicare/Medicaid recipients, were more likely to use in-office visits post-lockdown (p <0.05). Conclusion We identified disparities in the utilization of telemedicine in Pain Medicine, which may be due to socioeconomic factors such as lack of access to reliable internet access, cost of devices, and technological know-how. This emphasizes the need for further studies to better understand the reasons for and barriers to telemedicine use. This could help inform policymaking to safeguard equitable access to telemedicine use for pain care.

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Section: Discussionsupporting

confidence: 57%

“… 21–23 With its crux focused on connecting patients with healthcare providers via video-enabled virtual visits, telemedicine eliminated travel-related costs and reduced the burden of travel time, thereby ameliorating some traditional access-level barriers to treatment while maintaining patient satisfaction. 18 , 22 , 24 …”

Section: Introductionmentioning

confidence: 99%

Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice

Rockholt,

Addae,

Chee

et al. 2023

JPR

View full text Add to dashboard Cite

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“…A recent study by Jalilian et al found that 92% of patients seen via telemedicine within a pain division at an urban academic medical center were satisfied with their care via telemedicine. 58 Another study by Harnik et al found patients’ acceptance of telemedicine during the COVID-19 pandemic was high overall but lower among those with levels of pain and anxiety higher than the mean indicating telemedicine may not suffice for this subgroup. 59 Another recent narrative review detailed best practices for telehealth use and remote physical examinations.…”

Section: Discussionmentioning

confidence: 99%

Implementation and Preliminary Effectiveness of a Multidisciplinary Telemedicine Pilot Initiative for Patients with Chronic Non-Cancer Pain in Rural and Underserved Areas at a Major Academic Medical Center

Hayes

Gannon

Woodward

et al. 2023

JPR

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Background: Arkansas lacks adequate access to high-quality pain care, as evidenced, in part, by it having the second highest opioid prescribing rate in the United States. To improve access to high-quality treatment of chronic pain, we developed the Arkansas Improving Multidisciplinary Pain Care and Treatment (AR-IMPACT) Telemedicine Clinic, a multidisciplinary and interprofessional team of specialists who provide evidence-based pain management for patients with chronic pain. Methods: We conducted a single-arm pilot trial of the AR-IMPACT Telemedicine Clinic with rural, university-affiliated primary care clinics. We assessed the AR-IMPACT Telemedicine Clinic using an implementation framework and preliminary effectiveness measures. Specifically, we assessed 5 of the 8 implementation outcomes of the framework (ie, penetration, adoption, acceptability, appropriateness, and feasibility) using a mixed methods approach. To evaluate implementation outcomes, we used surveys, interviews, and administrative data. We used electronic health record data to measure preliminary effectiveness (ie, changes in average morphine milligram equivalents per day and pain and depression scores). Results:The AR-IMPACT team saw 23 patients that were referred by 13 primary care physicians from three rural, universityaffiliated primary care clinics over one year. Of the 19 patients willing to participate in the pilot study, 12 identified as women, 31.6% identified as Black, and over 50% had less than a bachelor's level education. Patients rated the clinic positively with high overall satisfaction. Referring physicians indicated high levels of appropriateness, acceptability, and feasibility of the program. AR-IMPACT team members identified several barriers and facilitators to the feasibility of implementing the program. No changes in preliminary effectiveness measures were statistically significant. Conclusion: Overall, the AR-IMPACT Telemedicine Clinic obtained moderate penetration and adoption, was highly acceptable to patients, was highly acceptable and appropriate to providers, and was moderately feasible to providers and AR-IMPACT team members.

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“…The field of anesthesiology was no exception; the American Society of Anesthesiologists (ASA) and the American College of Surgeons (ACS) officially called for the utilization of teleconsultations for preoperative evaluations to maintain medical services while limiting disease transmission [7,8]. Additionally, anesthesiologists increasingly utilized telemedicine for pain management in both rural and urban healthcare settings [9]. The in-person preoperative anesthesia consultation serves multiple purposes including patient education, optimization of comorbid conditions, and perioperative risk reduction [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Improvement in Adherance to Anesthesia Preoperative Appointment With Telemedicine: A Retrospective Analysis

Le,

Burton,

Tejeda

et al. 2024

Cureus

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Background: Amidst the coronavirus disease 2019 (COVID-19) pandemic, the sudden demand for virtual medical visits drove the expansion of telemedicine across all medical specialties. Current literature demonstrates limited knowledge of the impact of telehealth on appointment adherence, particularly in preoperative anesthesia evaluations. This study aims to describe the impact of telemedicine-based anesthesia evaluation and its effects on appointment completion.Methods: This was a retrospective, non-randomized, cohort study of adult patients at the University of California, Los Angeles, United States, who received preoperative anesthesia evaluations by telemedicine or in-person in an academic medical center. From January to September 2021, we evaluated telemedicine and in-person appointment completion in patients scheduled for surgery. The primary outcome was the incidence of appointment completion. The secondary outcomes included appointment no-shows and cancellations.Results: Of 1332 patients included in this study, 956 patients received telehealth visits while 376 patients received in-person preoperative anesthesia evaluations. Compared to the in-person group, the telemedicine group had more appointment completions (81.38% vs 76.60%), fewer cancellations (12.55% vs 19.41%), and no statistical difference in appointment no-shows (6.07% vs 3.99%). Compared to the in-person group, patients who received telemedicine evaluations were younger (55. 81 ± 18.38 vs 65.97 ± 15.19), less likely Native American and Alaska Native (0.31% vs 1.60%), more likely of Hispanic or Latino ethnicity (16.63% vs 12.23%), required less interpreter services (4.18% vs 9.31%), had more private insurance coverage (53.45% vs 37.50%) and less Medicare coverage (37.03% vs 50.53%).Conclusions: This study demonstrates that telemedicine can improve preoperative anesthesia appointment completion and decrease appointment cancellations. We also demonstrate potential shortcomings of telemedicine in serving patients who are older, require interpreter services, or are non-privately insured. These inequities highlight potential avenues to increase equity and access to telemedicine.

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Evaluation of Telemedicine Use for Anesthesiology Pain Division: Retrospective, Observational Case Series Study

Cited by 4 publications

References 34 publications

Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice

Implementing Telemedicine During the COVID-19 Pandemic: Disparities in Utilization in an Urban Pain Medicine Practice

Implementation and Preliminary Effectiveness of a Multidisciplinary Telemedicine Pilot Initiative for Patients with Chronic Non-Cancer Pain in Rural and Underserved Areas at a Major Academic Medical Center

Improvement in Adherance to Anesthesia Preoperative Appointment With Telemedicine: A Retrospective Analysis

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