Video Visits as a Substitute for Urological Clinic Visits

Abstract

Objective To evaluate whether video visits were being used as substitutes to clinic visits prior to COVID-19 at our institution's outpatient urology centers. Methods We reviewed 600 established patient video visits completed by 13 urology providers at a tertiary academic center in southeast Michigan. We compared these visits to a random, stratified sample of established patient clinic visits. We assessed baseline demographics and visit characteristics for both groups. We defined our primary outcome (“revisit rate”) as the proportion of additional healthcare evaluation (ie, office, emergency room, hospitalization) by a urology provider within 30 days of the initial encounter. Results Patients seen by video visit tended to be younger (51 vs 61 years, P <.001), would have to travel further for a clinic appointment (82 vs 68 miles, P <.001), and were more likely to be female (36 vs 28%, P = .001). The most common diagnostic groups evaluated through video visits were nephrolithiasis (40%), oncology (18%) and andrology (14.3%). While the 30-day revisit rates were higher for clinic visits (4.3% vs 7.5%, P = .01) primarily due to previously scheduled appointments, revisits due to medical concerns were similar across both groups (0.5% vs 0.67%; P = .60). Conclusions Video visits can be used to deliver care across a broad range of urologic diagnoses and can serve as a substitute for clinic visits.

Telepresence Robots at the Urology and Emergency Department: A Pilot Study Assessing Patients’ and Healthcare Workers’ Satisfaction

“…To our knowledge, this is the first study evaluating the applicability of telemedicine in unselected urological patients. Previous studies on telemedicine in urology have mostly reported encouraging results [10][11][12][13][14]. Notably, many ambulatory visits can be conducted satisfactorily using videoconferencing equipment [10,11,14,15].…”

“…Previous studies on telemedicine in urology have mostly reported encouraging results [10][11][12][13][14]. Notably, many ambulatory visits can be conducted satisfactorily using videoconferencing equipment [10,11,14,15]. Likewise, studies on the use of telepresence for rounds, telerounding, at urology departments have generally yielded positive results by including a highly selected patient group [4][5][6]16].…”

Projected US Urology Workforce per Capita, 2020-2060

“…Although urology has pioneered the integration of telemedicine to provide care for our patients, it is still largely unknown whether video visits in urology can serve as a substitute for clinic evaluations and how it affects clinical efficiency. 17 , 18 In addition, the patients who use telemedicine to access care tend to be younger and female, which may still preclude providing care for the elderly patient population. 17 However, we anticipate that telemedicine will continue to be an integral part of providing care for our patients and will be further used by the Medicare population as this population becomes more accustomed to technological advances required for telemedicine.…”

“… 17 , 18 In addition, the patients who use telemedicine to access care tend to be younger and female, which may still preclude providing care for the elderly patient population. 17 However, we anticipate that telemedicine will continue to be an integral part of providing care for our patients and will be further used by the Medicare population as this population becomes more accustomed to technological advances required for telemedicine.…”

Online access to male factor infertility care: the challenge of finding a specialist

“…Establishing closer collaboration and referral patterns with reproductive endocrinology colleagues locally can lead to coordinated care, but systemic initiatives to stimulate collaboration on a national level may be challenging. Improving access to reproductive urologists in underserved or rural areas through use of telemedicine or other outreach initiatives also offers great potential (26). In light of the current data, more easily accessible online search databases may be a simple and effective solution.…”