Telemedicine in the Evaluation and Management of Neurosurgical Spine Patients

Greven, Alex; McGinley, Beau; Malcolm, James G.; Boden, Scott D.; Rodts, Gerald E.; Refai, Daniel; Gary, Matthew F.

doi:10.1093/neuros/nyaa447_145

Cited by 3 publications

(3 citation statements)

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“…These findings are in contrast to those of Greven et al. (2021) who reported 95% were satisfied or very satisfied with their telehealth consultation. Our service has continued to use telehealth consultations for follow‐up appointments, but informal feedback from clinicians suggested the ability to validate a patient's symptoms by both the subjective and objective assessment in the first consultation allowed greater confidence when discharging after the first consultation.…”

Section: Discussioncontrasting

confidence: 99%

Was the impact of COVID‐19 on a spinal triage service as significant as expected? A retrospective service evaluation: Results and evaluation

Wood

Eveleigh

Dixon

et al. 2022

Musculoskeletal Care

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Objectives The aim of this evaluation was to review service outcomes for a spinal advanced practitioner physiotherapy (APP) triage service during COVID‐19. The evaluation compares outcomes gathered against pre‐pandemic data and evaluates the impact of the pandemic on service delivery. Design Service‐level data were extracted between 2019 and 2021 including: total referrals, new and follow‐up appointments, telehealth consultation rates, discharges at first appointment, magnetic resonance imaging and injection request rates. Multidisciplinary‐team (MDT) meeting notes with Spinal Surgeons were reviewed and surgical conversion calculated. Patient satisfaction data were collated using: Friends and Family test, specific questionnaires, individual and formal complaints and compliments, and telephone surveys. Analysis was performed by the lead author and results were compared between years using analysis of variance, as well as with previously reported data. Setting ‘Nottingham University Hospitals’ National Health Services Trust is a secondary care spinal unit, using APPs to triage, assess and manage spinal conditions. Results In 2020, 407 (22%; p = 0.02) less patients were referred to the service, however, there was a significant increase in the number of telehealth attendances (mean = 50% in 2020 from 2019, p = 0.005). Only 13% (n = 1342) patients were discussed at MDT, of which 8% (n = 808) were discussed for surgical consideration, and 36% (n = 268) were directly listed. High levels of patient satisfaction were reported by 89% (n = 1028 of 1160) patients. Conclusion This service evaluation demonstrates a statistically significant change in numbers of patients referred and telehealth attendances in the year of the pandemic (2020). Surgical conversion declined during the pandemic, and did not recover post‐pandemic.

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Section: Discussioncontrasting

confidence: 99%

Was the impact of COVID‐19 on a spinal triage service as significant as expected? A retrospective service evaluation: Results and evaluation

Wood

Eveleigh

Dixon

et al. 2022

Musculoskeletal Care

View full text Add to dashboard Cite

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“…However, telemedicine adoption among spine practices has been positive and demand is growing 1,3. In a recent study, 95% of spine patients seen via telemedicine were “satisfied” or “very satisfied” with their telemedicine visit, with 62% stating it was “the same” or “better” than previous in-person appointments 4. Due to these positive findings, recent studies have aimed to provide specific guidelines and a framework to allow for a more comprehensive spine patient evaluation, particularly focusing on the telemedicine physical examination 5–9…”

mentioning

confidence: 99%

Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients

Bovonratwet

Song

Kim

et al. 2022

Spine

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Study Design. A Retrospective cohort study. Objective. To (1) assess whether diagnoses and surgical plans established during a new patient telemedicine visit changed following an in-person evaluation and (2) determine any differences in perioperative outcomes between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. Summary of Background Data. Data on capability of telemedicine to deliver high-quality preoperative assessment without a traditional in-person interaction and physical examination is lacking. Materials and Methods. Records of patients who had a new patient telemedicine visit and indicated for surgery with documented specific diagnosis as well as surgical plans from a spine department at an urban tertiary center from April 2020 to April 2021 were reviewed. For a subset of patients that had a follow-up in-person evaluation before surgery, these diagnoses and plans were compared. Perioperative outcomes were compared between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. Results. A total of 166 patients were included. Of these, 101 patients (61%) only had a new patient telemedicine visit before surgery while 65 (39%) had a telemedicine visit followed by an inperson evaluation. There were no differences in the rate of case cancellations before surgery and patient-reported outcome measures between these two groups (P > 0.05). Of 65 patients who had both a telemedicine followed by an in-person visit, the diagnosis was unchanged for 61 patients (94%) and the surgical plan did not change for 52 patients (80%). The main reason for surgical plan change was due to updated findings on new imaging, 10 patients, (77%). Conclusions. The current study suggests that telemedicine evaluations can provide an effective means of preoperative assessment for spine patients.

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“…6 Other studies have found that patients who live further away and have longer travel times are more likely to prefer telemedicine. 7 It is reasonable to assume that patients who have more difficulty getting to in-person visits (i.e., require assistance or must miss work) would be more likely to prefer telemedicine. A reason for the difference in our analyses includes our small sample size; it is possible that we simply did not have sufficient power to detect these differences in preference.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine for Neurosurgery Consultations at a Pituitary Center of Excellence: Patient Preference and Willingness to Proceed with Surgery

Greven

Douglas

Couceyro

et al. 2021

J Neurol Surg B Skull Base

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Objective The purpose of this study was to evaluate pituitary tumor patient satisfaction with telemedicine, patient preference for telemedicine, potential socioeconomic benefit of telemedicine, and patients’ willingness to proceed with surgery based on a telemedicine visit alone. Methods 134 patients who had pituitary surgery and a telemedicine visit during the COVID-19 pandemic (4/23/20-3/4/21) were called to participate in a 13-part questionnaire. Chi-square, ANOVA, and Wilcoxon Rank Sum were used to determine significance. Result Of 134 patients contacted, 90 responded (67%). 95% were “satisfied” or “very satisfied” with their telemedicine visit, with 62% stating their visit was “the same” or “better” than previous in-person appointments. 82% of patients rated their telemedicine visit as “easy” or “very easy.” On average, patients saved 150 minutes by using telemedicine compared to patient reported in-person visit times. 77% of patients reported the need to take off work for in-person visits, compared to just 12% when using telemedicine. 49% of patients preferred in-person visits, 34% preferred telemedicine, and 17% had no preference. 50% of patients said they would feel comfortable proceeding with surgery based on a telemedicine visit alone. Patients with both initial evaluation and follow-up conducted via telemedicine were more likely to feel comfortable proceeding with surgery based on a telemedicine visit alone compared to patients who had only follow-up telemedicine visits (p=0.051). Conclusion Many pituitary patients patients are satisfied with telemedicine visits and feel comfortable proceeding with surgery based on a telemedicine visit alone. Telemedicine is an important adjunct to increase access to care.

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Telemedicine in the Evaluation and Management of Neurosurgical Spine Patients

Cited by 3 publications

References 0 publications

Was the impact of COVID‐19 on a spinal triage service as significant as expected? A retrospective service evaluation: Results and evaluation

Was the impact of COVID‐19 on a spinal triage service as significant as expected? A retrospective service evaluation: Results and evaluation

Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients

Telemedicine for Neurosurgery Consultations at a Pituitary Center of Excellence: Patient Preference and Willingness to Proceed with Surgery

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