Background Video consultations have proven to be an efficient source of support for patient-doctor interactions and have become increasingly used in orthopedics, especially during the COVID-19 pandemic. This study analyzed both patients’ and doctors’ acceptance of an orthopedic telemedical consultation (OTC) and compared the results of OTC examinations to the results of live consultation (LC) to identify discrepancies. Methods The study was carried out in an orthopedic department of a German hospital between 2019 and 2020. After written informed consent was obtained, patients voluntarily presented for follow-up by OTC and LC. The experience with and attitudes toward OTC among both patients and doctors was evaluated (using Likert scale-scored and open questions, 26 to 28 items). The results of the OTC and LC examinations were compared using a 12-item checklist. The data were analyzed by quantitative and qualitative statistics. Results A total of 53 patients were included, each of whom completed an OTC and an LC. The OTC was rated as pleasant, and the experience was rated as very satisfying (average rating on a 5-point Likert scale, with 1 indicating strong agreement: doctors: 1.2; patients: 1.3). Various technical and organizational challenges were identified. Compared to LC, OTC showed no significant differences in patient history or in inspection, palpation, or active range of motion results. Only for the functional or passive joint assessment did LC show significantly higher suitability (p < 0.05) than OTC. Recommendations for further procedures did not differ significantly between OTC and LC. Conclusions Because of the high acceptance and the objective benefits of OTC and the similarity of clinical results with LC, OTC is recommendable for orthopedic follow-up examinations. To better assess joint functionality, meaningful digital alternatives for established examination methods should be further investigated.
Introduction: Telemedical video consultations are a powerful support for patient–doctor interactions. For optimal digital settings, explanatory illustrations may be helpful for patients. This study analyzed patients' the attitude of patients to illustrations preparing for an orthopedic telemedical consultation (OTC).Methods: A leaflet with eight illustrations was designed and their acceptance and estimated necessity was evaluated among patients who had experienced an OTC (EXP-group) and others who had not (NOV-group) with a 12-item-questionnaire.Results: Sixty patients participated (n = 30 each group). All illustrations were evaluated positively. The EXP-group gave significantly higher ratings than the NOV-group for improved understanding by the given keywords of the illustrations (p = 0.046), preference for being informed by illustrations than by merely by a pure text (p = 0.023), better feeling of preparation for an OTC by the illustrations (p = 0.005), and the impression of a simplified process of the OTC by the illustrations (p = 0.012).Discussion: While the illustrations were well-accepted by the participants, significant differences were revealed between the valuation of single aspects by patients, depending on a previous experience with an OTC. Therefore, a leaflet with explanatory illustrations may be helpful in preparing patients for an OTC to support the digital patient–doctor contact.
Introduction Video consultations have proven to be a powerful support tool for patient–doctor interactions in general, not only during the COVID-19 pandemic. This study analyzed the feasibility and usefulness of orthopedic telemedical consultations (OTCs) for orthopedic patients at the interface of a clinic and general practitioners. Methods The study was carried out at an orthopedic department of a German hospital between April 2020 and October 2020. After written informed consent was obtained, general practitioners (GPs) of a large adjunct health region could present their patients with orthopedic pathologies to specialists at the hospital via OTCs instead of the usual live consultation (LC). The patients, specialists and GPs were evaluated for their OTC experience and attitude (5-point Likert-scale and open questions, 19 to 27 items). Results A total of 89 video consultations took place with 76 patients, 16 GPs and six specialists. The average distance between the GPs/patients and the hospital was 141.9 km. The OTCs were rated as pleasant, and the experience was rated as very satisfying (average Likert-Scale rating, with 5 as strong agreement: specialists = 4.8; GPs = 4.9; patients = 4.7). Following the OTC, a LC was not necessary in 76.4% of cases. Patients with a necessary LC after an OTC showed significantly lower satisfaction with the OTC (p = 0.005). Time savings, the elimination of travel and quick contact with orthopedic consultants were positively highlighted by the participants. A total of 123 recommendations for further treatment were given, such as the initiation of physiotherapy/medication and the use of imaging diagnostics. Different technical and organizational challenges could be identified and addressed. Discussion The vast majority of the participants stated they had a very positive impression. In particular, the potential savings in travel and time as well as straightforward contact with specialists were rated positively. However, limitations in the assessment of initial presentations of complex medical conditions were also highlighted. Further studies on OTCs with a consultative health professional may show other fields of use for this mode of interdisciplinary remote communication.
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