The Efficacy of Telehealth for the Treatment of Spinal Disorders: Patient-Reported Experiences During the COVID-19 Pandemic

Abstract

Background The use of telehealth saw a rapid surge during the early months of the COVID-19 pandemic. There remains little data on how effectively telehealth replicates traditional office visits in the treatment of spinal disorders and how telehealth is perceived by patients with spinal disorders. Questions/Purposes We sought to evaluate patient satisfaction with telehealth visits as a platform for delivering care for the treatment of spinal pathology. Methods Patients undergoing a telehealth visit with providers specializing in the treatment of spinal disorders (one surgeon and two physiatrists) were provided with an anonymous, online survey. Data on patient satisfaction, effectiveness of the telehealth visit (in comparison with in-person visits), and clarity of communication were collected through 5-point Likert scales; visit characteristics and free-text responses were also collected. Results Eighty-four patients responded to the survey. Their attitudes were largely positive, with an overall mean patient satisfaction score of 4.79. Patients gave high scores for clarity of communication during the visit, and for satisfaction with the formulation of treatment plans and their ability to ask questions, they gave the lowest scores to the effectiveness of telemedicine in replacing an in-person visit and ease of interface navigation. Conclusions The high overall patient satisfaction reported by our patients seeking care for a spinal pathology supports the growing body of evidence promoting the use of telehealth for orthopedic care. Further research is needed in a standardized telehealth examination of patients with spinal disorders. Electronic supplementary material The online version of this article (10.1007/s11420-020-09808-x) contains supplementary material, which is available to authorized users.

Appropriate Telemedicine Utilization in Spine Surgery

“…[1][2][3] Spine patients have generally been very satisfied with telemedicine visits and have rated them highly for the clarity of communication, formulation of treatment plans, and the ability to ask questions. [9][10][11] Due to such rapid introduction of the technology as well as changing medical, political, and legal landscapes, several uncertainties surrounding the optimal utilization of telemedicine in spine surgery persist. 12 Previous studies have shown considerable differences in the definition of telemedicine across geographic regions (e.g., telephone visits vs. video visits).…”

XR (Extended Reality: Virtual Reality, Augmented Reality, Mixed Reality) Technology in Spine Medicine: Status Quo and Quo Vadis

“…Haddas et al [82] reported that cameras and gait analysis platforms have described patterns of gait dysfunction caused by conditions such as myelopathy. In addition, patients who receive telemedicine for spine-related complaints have given high ratings for overall satisfaction and ease of use [85].…”

“…Although telemedicine spread rapidly during the COVID-19 pandemic, it has not yet been determined how best to perform an objective physical examination of the spine in the remote setting [85]. The limitations of telemedicine in performing a physical examination or collecting proper manual neurological findings in the field of spine medicine have been the biggest obstacle to adoption by spinal surgeons [85].…”

“…Although telemedicine spread rapidly during the COVID-19 pandemic, it has not yet been determined how best to perform an objective physical examination of the spine in the remote setting [85]. The limitations of telemedicine in performing a physical examination or collecting proper manual neurological findings in the field of spine medicine have been the biggest obstacle to adoption by spinal surgeons [85]. Guidelines have been developed for the implementation of virtual physical examinations, including specific testing methods for spine surgeons to assess the physical function, motor strength, and sensation [17,[86][87][88]; however, these are still insufficient.…”

Patient Experiences of Telemedicine in Spine Care

“…Though historically underutilized in orthopedics due to legislative barriers, technological limitations, and physician hesitation, 1 telemedicine's efficacy, [2][3][4][5] cost-effectiveness, [6][7][8][9][10] and high levels of patient satisfaction 3,[10][11][12][13][14] have been demonstrated in emerging literature. More recently, within in the realm of spine care, telemedicine was shown to be both safe and effective, [15][16][17] and groups began proposing standardized virtual neurologic exams. [18][19][20][21] Furthermore, telemedicinebased spine surgical plans were found to be accurate.…”