Utilization of Telemedicine Virtual Visits in Pediatric Spinal Deformity Patients: A Comparison of Feasibility and Patient Satisfaction at a Large Academic Center

Abstract

Background: Telemedicine platforms have been developed to support the convenient delivery of health care services to their patients while maintaining appropriate quality of care. However, it is unclear whether they can be utilized effectively in patients with pediatric spinal deformity (PSD). Therefore, this study aimed to evaluate the feasibility and patient satisfaction associated with virtual visit (VV) utilization in PSD patients in comparison to general pediatric orthopaedic indications. Methods: Of the 482 VVs offered to pediatric orthopaedic patients at a large academic health care system between January 1, 2017, and December 31, 2018, a total of 189 VVs conducted by board-certified orthopaedic surgeons were included in the final analysis. Patient satisfaction scores were collected at the end of each VV by patient and parent rankings of the surgeon and the telemedicine service. Data on patients, visits, and connectivity sessions characteristics were collected and statistically compared between PSD visits (n=33) versus those conducted for general pediatric orthopaedic indications (n=156). Results: Although PSD patients were older (15±3.7 vs. 12±4.7 y; P<0.01), mostly female (76% vs. 47%, P=0.003), and had longer VVs (8±4.6 vs. 5±3.6 min; P=0.003) versus their general pediatric orthopaedic counterparts, they demonstrated similarly high satisfaction scores for surgeon performance (5±0 vs. 4.8±0.1 points; P=0.08) and overall satisfaction (3±2.4 vs. 3.5±2.1; P=0.23). Approximately 80% of all VVs were conducted over mobile devices. Wait time was substantially less for PSD VVs relative to subsequent office visits (13±10 vs. 41±30 min; P<0.001). Conclusions: Our analysis found that telemedicine VVs provided a convenient alternative to traditional in-office visits for PSD patients. Specifically, we found that PSD patients received faster care with comparable satisfaction. The findings of our present analysis should encourage health care systems to continually evaluate and implement telehealth platforms to improve both the accessibility and appropriate quality of care. Level of Evidence: Level IV.

Spine Patient Satisfaction With Telemedicine During the COVID-19 Pandemic: A Cross-Sectional Study

“…The potential for telemedicine to improve access to care and reduce costs lead some practices to investigate telemedicine for orthopedic outpatient care, consultation, and rehabilitation even before the COVID-19 pandemic. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] These studies demonstrated that telemedicine visits are safe, feasible, associated with high patient satisfaction, and cost-effective in patients with orthopedic concerns. 11,[15][16][17][18][19][20][21][22][23][24] Previous studies included general orthopedic, pediatric orthopedic, sports medicine, arthroplasty, and trauma practices without large numbers of adult patients presenting to spine surgeons.…”

Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 1

“…However, telephone and video appointments are preferred where possible. Virtual clinics have run successfully for many years [23][24][25], but during the COVID-19 pandemic regulations have been eased to allow greater usage [26].…”

The Virtual Foot and Ankle Physical Examination

“…16 Atanda et al report a similarly large difference in average wait times, 2 minutes for telehealth vs 33 minutes for in-person, as well as average visit times, 15 minutes vs 68 minutes on average. 2 Though patients report significant time saved for telehealth appointments given the nature of a virtual visit, studies have suggested that for clinicians, telehealth requires more flexibility, and potentially more preparation and overall time spent, 12,16 though to date the literature has not explored these points in detail. In addition to saving time for patients during a single visit, telehealth services may also prevent further future utilization of resources.…”