Novel Pre- and Postoperative Care Using Telemedicine

Ferrari-Light, Dana; Geraci, Travis C.; Chang, Stephanie H.; Cerfolio, Robert J.

doi:10.3389/fsurg.2020.596970

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…These have been shown to be effective and interestingly, some have argued that there is no point going back to face-to-face clinics [ 136 ]. This is not a perfect panacea, as there may be certain aspects of the clinical consult which are not possible to complete virtually, and it may be more challenging for clinicians to build rapport via these means [ 138 ]. Furthermore, lack of access to telemedicine may potentially widen socioeconomic gaps [ 138 ].…”

Section: Scope Of Erps and Special Casesmentioning

confidence: 99%

Framework, component, and implementation of enhanced recovery pathways

2022

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The introduction of enhanced recovery pathways (ERPs) has led to a considerable paradigm shift towards evidence-based, multidisciplinary perioperative care. Such pathways are now widely implemented in a variety of surgical specialties, with largely positive results. In this narrative review, we summarize the principles, components and implementation of ERPs, focusing on recent developments in the field. We also discuss ‘special cases’ in ERPs, including: surgery in frail patients; emergency procedures; and patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2/COVID-19). Supplementary Information The online version contains supplementary material available at 10.1007/s00540-022-03088-x.

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Section: Scope Of Erps and Special Casesmentioning

confidence: 99%

Framework, component, and implementation of enhanced recovery pathways

2022

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“…Even though telemedicine has been utilized previously, the COVID-19 pandemic exponentially increased the resources and coverage available for telemedicine. The US Center for Medicare and Medicaid Services (CMS), for example, expanded its coverage for telemedicine visits, adding to the development and use of telemedicine platforms (17). Grenda et al described their hospital system's transition to telemedicine services during the COVID-19 pandemic (18).…”

Section: Telemedicine and Outpatient Care During The Covid-19 Pandemicmentioning

confidence: 99%

Managing Scarcity: Innovation and Resilience During the COVID-19 Pandemic

Pozzi

Zuckerman²,

Son³

et al. 2021

Front. Surg.

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The Coronavirus Disease 2019 (COVID-19) pandemic remains a disruptive force upon the health care system, with particular import for thoracic surgery given the pulmonary pathophysiology and disease implications of the virus. The rapid and severe onset of disease required expedient innovation and change in patient management and novel approaches to care delivery and nimbleness of workforce. In this review, we detail our approaches to patients with COVID-19, including those that required surgical intervention, our expedited and novel approach to bronchoscopy and tracheostomy, and our expansion of telehealth. The pandemic has created a unique opportunity to reflect on our delivery of care in thoracic surgery and apply lessons learned during this time to “rethink” how to optimize resources and deliver excellent and cutting-edge patient care.

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“…1,2 In the field of surgery, telemedicine is utilized by a broad range of subspecialties and has demonstrated feasibility, diagnostic accuracy, high levels of patient and clinician satisfaction, and acceptable patient outcomes. [3][4][5][6][7][8][9] Additionally, day-of-surgery cancellation rates are unchanged. 10,11 We define total preoperative surgical telemedicine as the patient completing all preoperative surgical clinical encounters virtually.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes and Hospital Utilization Among Patients Undergoing Bariatric Surgery With Telemedicine Preoperative Care

et al. 2023

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ImportanceBariatric surgery is the mainstay of treatment for medically refractory obesity; however, it is underutilized. Telemedicine affords patient cost and time savings and may increase availability and accessibility of bariatric surgery.ObjectiveTo determine clinical outcomes and postoperative hospital utilization for patients undergoing bariatric surgery who receive fully remote vs in-person preoperative care.Design, Setting, and ParticipantsThis cohort study comparing postoperative clinical outcomes and hospital utilization after telemedicine or in-person preoperative surgical evaluation included patients treated at a US academic hospital. Participants underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy after telemedicine or in-person preoperative surgical evaluation between July 1, 2020, to December 22, 2021, or January 1, 2018, to December 31, 2019, respectively. Follow-up was 60 days from date of surgery.ExposuresTelemedicine-based preoperative care.Main Outcomes and MeasuresClinical outcomes, including operating room delay, procedure duration, length of hospital stay (LOS), and major adverse events (MAE), and postoperative hospital resource utilization, including emergency department (ED) visit or hospital readmission within 30 days of the surgical procedure.ResultsA total of 1182 patients were included; patients in the telemedicine group were younger (mean [SD] age, 40.8 [12.5] years vs 43.0 [12.2] years; P = .01) and more likely to be female (230 of 257 [89.5%] vs 766 of 925 [82.8%]; P = .01) compared with the control group. The control group had a higher frequency of comorbidity (887 of 925 [95.9%] vs 208 of 257 [80.9%]; P &lt; .001). The telemedicine group was found to be noninferior to the control group with respect to operating room delay (mean [SD] minutes, 7.8 [25.1]; 95% CI, 5.1-10.5 vs 4.2 [11.1]; 95% CI, 1.0-7.4; P = .002), procedure duration (mean [SD] minutes, 134.4 [52.8]; 95% CI, 130.9-137.8 vs 105.3 [41.5]; 95% CI, 100.2-110.4; P &lt; .001), LOS (mean [SD] days, 1.9 [1.1]; 95% CI, 1.8-1.9 vs 2.1 [1.0]; 95% CI, 1.9-2.2; P &lt; .001), MAE within 30 days (3.8%; 95% CI, 3.0%-5.7% vs 1.6%; 95% CI, 0.4%-3.9%; P = .001), MAE between 31 and 60 days (2.2%; 95% CI, 1.3%-3.3% vs 1.6%; 95% CI, 0.4%-3.9%; P &lt; .001), frequency of ER visits (18.8%; 95% CI, 16.3%-21.4% vs 17.9%; 95% CI, 13.2%-22.6%; P = .03), and hospital readmission (10.1%; 95% CI, 8.1%-12.0% vs 6.6%; 95% CI, 3.9%-10.4%; P = .02).Conclusions and RelevanceIn this cohort study, clinical outcomes in the telemedicine group were not inferior to the control group. This observation suggests that telemedicine can be used safely and effectively for bariatric surgical preoperative care.

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Novel Pre- and Postoperative Care Using Telemedicine

Cited by 11 publications

References 18 publications

Framework, component, and implementation of enhanced recovery pathways

Framework, component, and implementation of enhanced recovery pathways

Managing Scarcity: Innovation and Resilience During the COVID-19 Pandemic

Clinical Outcomes and Hospital Utilization Among Patients Undergoing Bariatric Surgery With Telemedicine Preoperative Care

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