by Elizabeth Hofheinz, M.P.H., M.Ed.
When a team of researchers from Geisinger Medical Center in Danville, Pennsylvania pondered the issue of telemedicine and its effectiveness, they wondered specifically about travel burden, visit time, and patient satisfaction between an initial postoperative telemedicine visit and a second, traditional, in-person visit.
Their work, “Telemedicine After Upper Extremity Surgery: A Prospective Study of Program Implementation,” is published in the September 1, 2020 edition of The Journal of Hand Surgery.
Dovetailing with existing plans
Co-author Louis Grandizio, D.O. is with the Department of Orthopaedic Surgery at Geisinger and told OSN, “I work in a rural, academic center and we have patients in our region that need to drive as far as 2-3 hours in order to access orthopaedic subspeciality care. This study was conducted prior to the COVID pandemic, so at the time we were interested in starting this program as a way to decrease the travel burden for patients. Additionally, telemedicine allowed for some degree of improved access for patients, as these visits could be conducted outside of ‘normal’ clinic hours (between OR cases, etc).”
“Fifty-seven of 87 patients (66%) who met the inclusion criteria elected to participate in the study,” wrote the authors. “A cell phone was utilized by 89% of patients and 88% of visits were performed from the patient’s home. There were 4 technological complications during the study period (7%). Mean round-trip travel distance for the in-clinic visit was 60 miles with an average drive time of 85 minutes. Visit times were significantly shorter with telemedicine (7 minutes vs 38 minutes). Telemedicine was preferred by 90% of patients for subsequent encounters. All 4 clinical complications were recognized during the telemedicine visit.”
As for one burning question about telemedicine…
“Overall, telemedicine was efficient in terms of saving people travel time and decreasing visit times for postoperative care after these lower complexity procedures,” stated Dr. Grandizio. “Another important element from this study is that we were able to recognize post-operative complications during the telemedicine visits. We did not notice any decreases in patient satisfaction for virtual visits compared to in-person visits.”
“Most surgeons have some experience with telemedicine because of the pandemic, and I think telemedicine (in some form) is here to stay. Telemedicine has a number of advantages for patients, particularly with respect to decreasing travel burdens. Going forward, more research is needed to better understand the limitations of the telemedicine physical exam compared to a traditional, in-person physical exam.”