Are Patients Willing to Engage in Telemedicine for Their Care: A Survey of Preuse Perceptions and Acceptance of Remote Video Visits in a Urological Patient Population

Viers, Boyd R.; Pruthi, Sandhya; Rivera, Marcelino; O’Neil, Daniel A.; Gardner, Matthew R.; Jenkins, Sarah M.; Lightner, Deborah J.; Gettman, Matthew T.

doi:10.1016/j.urology.2014.12.064

Cited by 76 publications

(61 citation statements)

References 19 publications

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“…Patients are willing to receive urological care through telemedicine and do not view the practice negatively. 8 Urological telemedicine has been studied in a small number of pediatric populations and has been found to provide better continuity of care by eliminating distance barriers and reducing the burden on families travelling to bring their children to more traditional appointments. 9,10 Studies in the adult population have so far been mainly limited to the application of remote telesurgery, with the advent of robotic surgical systems.…”

Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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Introduction: Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods: Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results: Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions: Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists.

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Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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“…Patients are willing to participate in telemedicine, especially if they travel large distances to see their physician, which is particularly germane to rural areas. 32 Virtual consultation, teleconferenced followup care, and remote rounds may be increasingly incorporated into clinical practice thereby broadening the geographic footprint of a practice. 33,34 Reimbursement for telemedicine, Health Insurance Portability and Accountability Act (HIPAA) compliance, technical challenges particularly in rural communities, health literacy, and lack of ability to perform procedures must be overcome prior to widespread adoption.…”

Section: Discussionmentioning

confidence: 99%

Forecasting Limited Access to Urology in Rural Communities: Analysis of the American Urological Association Census

Cohen

Fergus

Lindsey

et al. 2019

The Journal of Rural Health

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Objective: To assess an aging subspecialty workforce and growing population that portends challenges in meeting patient care needs. We hypothesized that rural physicians are retiring at higher rates than their urban counterparts in the United States and that this represents a bellwether for workforce challenges at large. Methods: We analyzed data from the 2014-2016 American Urological Association Census, a sample-weighted representative survey of urologists, as a case study for subspecialists. We compared urologists who work in rural regions to nonrural regions on available characteristics. Results: In 2016, rural urologists accounted for 2.4% of 12,186 practicing urologists in the United States. General urology remained the focus of 90% of rural urologists, compared to 59% of nonrural urologists (P = .03). Alarmingly, 48% of rural physicians were >65 years old in 2016 compared to 29% in 2014, and 33% of rural urologists were solo practitioners compared to 9% of nonrural urologists (P < .01). The planned retirement age for rural physicians increased from 68 in 2014 to 73 in 2016 (P trend = .02). The percentage of rural practice urologists has remained stable since 2014. Conclusions: Rural urologists are older and provide more general urological care than their nonrural counterparts. Rural urologists are postponing retirement. Although this might be due to personal desires and financial goals, it may also be due to a relative absence of potential junior partners. Given that almost 50% of rural urologists were older than 65 in 2016, this is not a sustainable solution to an impending shortage of physicians. Greater innovation in telemedicine or alternative care models will soon be needed.

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“…44 The. technology components of home telehealth, including glucometers, oximeters, and digital scales, have been available for many years as standalone devices.…”

Section: Improving the Individual Experience Of Carementioning

confidence: 99%