Implications for Telemedicine for Surgery Patients After COVID-19: Survey of Patient and Provider Experiences

Abstract

Introduction The coronavirus disease 2019 (COVID-19) pandemic has expanded the utilization of telemedicine in clinical practice to minimize potential risks to both patients and providers. We aim to describe the perception of telemedicine by both surgical patients and providers to understand the preferences for future incorporation in future surgical practice. Methods An anonymous survey was administered to providers that transitioned clinic visits to telemedicine encounters since the start of the COVID-19 pandemic. In the second part of the study, patients who underwent video telemedicine appointments answered survey questions via telephone. Results Twenty-six out of 36 (72.7%) providers responded. Over 75% reported that they could effectively communicate with patients over telemedicine. Six (23.1%) reported that they could adequately assess surgical sites. Of 361 patients, 187 consented to the study (consent rate 51.8%). Among patients, the most common result to choose a telemedicine appointment was to avoid the risk of COVID-19 transmission (84, 44.9%), though the minority reported that they would choose telemedicine after the pandemic (64, 34.2%). Those patients who would choose an in-person visit were more likely to have a higher Charlson Comorbidity Score, body mass index, and use friends or family for transportation. In open-ended feedback, patients suggested that telemedicine would be better suited for long-term follow-up rather than the immediate postoperative setting. Conclusions Patients and providers reported a high degree of satisfaction using telemedicine during the COVID-19 pandemic but noted concern with limited physical examinations. Telemedicine may be suited for preoperative evaluation and medium-term and long-term postoperative follow-up for surgical patients.

A Review of Patient Satisfaction and Experience with Telemedicine: A Virtual Solution During and Beyond COVID-19 Pandemic

“…26 For rehabilitation, 80% of the virtual visits were for follow-ups for established issues. 27 The main benefits of telemedicine reported by patients were time saved due to lesser traveling 3,7,20,22,23,[27][28][29][30][31][32][33] and waiting in queues, 20,23,29,31,34 cost efficiency, 3,27,29,30,32,33,35 convenience, 7,26,27,31,33,[36][37][38] , and accessibility. 7,25,32,[35][36]39 Telemedicine was found satisfactory on various outcome measures such as addressing patients' concerns and questions, 38 communication with health care providers, 3,32 development of a treatment plan, 25,27 comprehensibility of disease, 31 usefulness, 23,24,…”

“…7,[20][21][22][23][24][25][26]29,30,33,40 However, in case of surgery, only minority of patients (34.2%) agreed to continue telemedicine after the COVID-19 pandemic. 3 Few studies examined the factors affecting the satisfaction levels, 19,25,27,40 preference for continuing consultation, 21 and method of consultation. 28 Age, sex, education, and dependence on others for the use of WhatsApp or accessibility of private vehicle did not significantly impact the preference for continuing teleconsultation.…”

“…Health care providers were also satisfied with the experience of teleconsultations 3,25,[28][29][30]39,40 and agreed that it was not associated with increased workload. 28 Zhu et al 3 found that most of the doctors were able to effectively answer patients' concerns (23/26, 88.5%), review laboratory tests with patients (22/26, 84.6%), and see and hear patients suitably (20/26, 76.9%). Ashry and Alsawy 30 found that 90% of doctors were satisfied with audio and video transmission and 80% were able to perform remote examination satisfactorily.…”

“…Ashry and Alsawy 30 found that 90% of doctors were satisfied with audio and video transmission and 80% were able to perform remote examination satisfactorily. In case of surgery, 3 rare cancers such as sarcomas, 28 and sports and musculoskeletal medicine practice, 25 the providers found telemedicine to be well suited for follow-up encounters. In six out of seven studies, health care providers expressed willingness to use telemedicine in the future.…”

“…COVID-19 has already impacted 223 countries/ territories with more than 88 million cases and 1.9 million deaths as of January 10, 2021 2 leading to a severe burden on the health care system across the globe. 3 Health care providers postponed several routines, elective care, and outpatient services 4,5 due to extensive deployment of medical resources in the treatment of COVID-19 patients and to decrease the risk of virus transmission. Moreover, faceto-face consultations have been disrupted because of hesitation in consulting doctors in hospital setting.…”