To Infinity and Beyond: The Past, Present, and Future of Tele-Anesthesia

Abstract

Because the scope of anesthesia practice continues to expand, especially within the perioperative domain, our specialty must continually examine technological services that allow us to provide care in innovative ways. Telemedicine has facilitated the remote provision of medical services across many different specialties, but it remains somewhat unclear whether the use of telemedicine would fit within the practice of anesthesiology on a consistent basis. There have been several reports on the successful use of telemedicine within the preoperative and intraoperative realm. However, patient selection, patient and provider satisfaction, case cancellation rates, equipment reliability, and security of protected health information are just some of the issues that require further examination. This article seeks to review comprehensively the available literature related to the use of telemedicine within the preoperative, intraoperative, and postoperative phases of anesthetic care as well as analyze the major hurdles often encountered when implementing a teleconsultation service. Security of connection, data storage and encryption, federal and state medical licensure compliance, as well as overall cost/savings analysis are a few of the issues that warrant further exploration and research. As telemedicine programs develop within the perioperative arena, it is imperative for institutions to share knowledge, successes, and pitfalls to improve the delivery of care in today’s technology-driven medical landscape.

A Retrospective Analysis of Patients Undergoing Telemedicine Evaluation in the PreAnesthesia Testing Clinic at H. Lee Moffitt Cancer Center

“…The application of telemedicine to the field of anesthesiology and perioperative medicine is still in its nascency with significant potential to impact patient outcomes and satisfaction. 10 …”

“… 2 Subsequent studies have likewise found high patient and provider satisfaction with no increase in day-of-surgery (DOS) cancellations when using telemedicine for preoperative assessment. 3 - 12 Furthermore, patients who underwent telemedicine evaluation were found to save significant time, distance, and cost associated with travel and in some cases, a shorter duration of the evaluation itself. 4 , 6 , 9 , 13 These savings were found both in rural and metropolitan settings.…”

“…14 Since the onset of the COVID-19 pandemic, it has seen rapid growth, although issues surrounding limited physical examination, reimbursement, privacy concerns, and interstate licensing remain. 1 , 10 , 15 …”

Recent advances in research, training and teaching in anaesthesia and critical care

“…The application of telemedicine to perioperative care maybe the most obvious evidence of how consumer technology influences anaesthesia practice. [ 31 ] Anaesthesia information management systems (AIMS) are becoming more widely used, and there is increased interest in using AIMS data for intraoperative clinical decision support (CDS). The possible benefits of CDS for anaesthesia include better patient safety, billing accuracy, and compliance.…”

Cerebrovascular Accident Manifesting as Altered Mental Status During a Telehealth Visit: Preoperative Evaluation in the COVID-19 Era

“…The adoption of telehealth for preoperative evaluation clinics has gained some traction to reach patients who may not otherwise present to a clinic [5,6]. Patients who require multiple short visits for preoperative optimization, such as those enrolled in smoking cessation [7] or weight loss [8] programs have shown benefit from telehealth visits.…”