Virtual Orthopaedic Examination of the Lower Extremity

Zhai, Kevin; Rothfusz, Christopher A; Minkara, Anas; Genin, Jason; Horton, Scott; King, Dominic; Schaffer, Jonathan; Piuzzi, Nicolás S.

doi:10.2106/jbjs.rvw.21.00047

Cited by 7 publications

(7 citation statements)

References 56 publications

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“…The effective treatment achieved remotely was already presented in the literature [29][30][31]45,[51][52][53][54][55]. The treatment of undisplaced fractures, post-operative wounds [15,56], the injuries of the neck [45,51,52], wrist [57], knee [29,31,53], foot, and ankles [30,54,55] belong to the most frequently managed in orthopedic practice with telemedicine.…”

Section: Discussionmentioning

confidence: 99%

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Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Glinkowski

2022

IJERPH

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The COVID-19 pandemic has caused a substantial intensification of the telemedicine transformation process in orthopedics since 2020. In the light of the legal regulations introduced in Poland, from the beginning of the SARS-CoV-2 pandemic, physicians, including orthopedic surgeons, have had the opportunity to conduct specialist teleconsultations. Teleconsultations increase epidemiological safety and significantly reduce the exposure of patients and medical staff to direct transmission of the viral vector and the spread of infections. The study aimed to describe diagnoses and clinical aspects of consecutive orthopedic teleconsultations (TC) during the pandemic lockdown. The diagnoses were set according to the International Classification of Diseases (ICD-10). Hybrid teleconsultations used smartphones and obligatory Electronic Health Record (EHR) with supplemental voice, SMS, MMS, Medical images, documents, and video conferencing if necessary. One hundred ninety-eight consecutive orthopedic teleconsultations were served for 615 women and 683 men (mean age 41.82 years ± 11.47 years). The most frequently diagnosed diseases were non-acute orthopedic disorders “M” (65.3%) and injuries “S” (26.3%). Back pain (M54) was the most frequent diagnosis (25.5%). Although virtual orthopedic consultation cannot replace an entire personal visit to a specialist orthopedic surgeon, in many cases, teleconsultation enables medical staff to continue to participate in providing medical services at a sufficiently high medical level to ensure patient and physician. The unified approach to TC diagnoses using ICD-10 or ICD-11 may improve further research on telemedicine-related orthopedics repeatability. Future research directions should address orthopedic teleconsultations’ practical aspects and highlight legal, organizational, and technological issues with their implementations.

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Section: Discussionmentioning

confidence: 99%

“…A virtual orthopedic examination is becoming the most discussed topic in clinical orthopedic telemedicine. The physician must therefore acquire specific skills to verify the complaints of the patient during anamnesis as well during the virtually precise physical examination [28][29][30][31]53].…”

Section: Discussionmentioning

confidence: 99%

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Glinkowski

2022

IJERPH

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“…Lower satisfaction from teleconsultation could also be due to the inability of the patient or relative to express themselves adequately on a virtual platform [ 17 , 18 ]. Despite many authors attempting to describe a virtual examination for teleconsultation, the incorporation and streamlining of these processes will take time and practice [ 19 , 20 ]. Orthopedic services rely on a detailed physical examination as well as radiological tests of the patient to assess the disease and pathology, which may not be possible in all cases leading to further dissatisfaction.…”

Section: Discussionmentioning

confidence: 99%

Patient Preferences Regarding Telemedicine to In-person Consultation: A Questionnaire-Based Survey

Kumar

Sinha

et al. 2022

JOIO

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Introduction Telemedicine has been evolving over the last two decades; however, with the advent of the COVID 19 pandemic, its utility and acceptance have drastically increased. Most studies report increasing acceptability and satisfaction rates. This study aimed to assess patient preferences regarding telemedicine to in-person consultations and to attempt to assess the factors driving these preferences. Material and Methods A questionnaire-based cross-sectional study was conducted for patients who had both teleconsultation and in-person consultation in the orthopedic outpatient. After obtaining consent to participate in the study, the patients were divided into broad clinical categories and responses were recorded regarding the treatment of illness by the doctor and opinions regarding telemedicine. Most questions were in yes/no or a Likert-based questionnaire. Mean, median, percentage and proportions were used for statistical analysis of the data. Results The study group included 264 patients, with the majority with fractures and dislocations. Most patients (55.7%) were comfortable using the software for teleconsultation, and half the respondents found telemedicine convenient. A large percentage of the study group preferred in-person consultation to teleconsultation (58.7%), and the primary reasons for discontinuing teleconsultation were dissatisfaction during the interaction with the doctor and poor connectivity to telecommunication networks. Conclusion Telecommunication has high acceptance and satisfaction, but many factors limit its acceptance in developing countries.

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“…Figure 1 presents patient pathways and illustrates a framework to aid decision-making with telemedicine. 18,19,24,25…”

Section: Introductionmentioning

confidence: 99%

Telehealth for a better service delivery in orthopaedic surgery

Grandhi,

Fontalis,

Raj

et al. 2023

Bone Joint J

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Telehealth has the potential to change the way we approach patient care. From virtual consenting to reducing carbon emissions, costs, and waiting times, it is a powerful tool in our clinical armamentarium. There is mounting evidence that remote diagnostic evaluation and decision-making have reached an acceptable level of accuracy and can safely be adopted in orthopaedic surgery. Furthermore, patients’ and surgeons’ satisfaction with virtual appointments are comparable to in-person consultations. Challenges to the widespread use of telehealth should, however, be acknowledged and include the cost of installation, training, maintenance, and accessibility. It is also vital that clinicians are conscious of the medicolegal and ethical considerations surrounding the medium and adhere strictly to the relevant data protection legislation and storage framework. It remains to be seen how organizations harness the full spectrum of the technology to facilitate effective patient care.Cite this article: Bone Joint J 2023;105-B(8):843–849.

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Virtual Orthopaedic Examination of the Lower Extremity

Abstract: Telemedicine has become an emerging necessity in the practice of orthopaedic surgery following the paradigm shift that was brought on by the COVID-19 pandemic.» Physical examination is an integral component of orthopaedic care and plays a crucial role in diagnosis.

Cited by 7 publications

References 56 publications

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Patient Preferences Regarding Telemedicine to In-person Consultation: A Questionnaire-Based Survey

Telehealth for a better service delivery in orthopaedic surgery

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