Assessing Telemedicine Efficiency in Follow-up Care With Video Consultations for Patients in Orthopedic and Trauma Surgery in Germany: Randomized Controlled Trial

Abstract

Background Telemedicine can help mitigate important health care challenges, such as demographic changes and the current COVID-19 pandemic, in high-income countries such as Germany. It gives physicians and patients the opportunity to interact via video consultations, regardless of their location, thus offering cost and time savings for both sides. Objective We aimed to investigate whether telemedicine can be implemented efficiently in the follow-up care for patients in orthopedic and trauma surgery, with respect to patient satisfaction, physician satisfaction, and quality of care. Methods We conducted a prospective randomized controlled trial in a German university hospital and enrolled 60 patients with different knee and shoulder conditions. For follow-up appointments, patients received either an in-person consultation in the clinic (control group) or a video consultation with their physician (telemedicine group). Patients’ and physicians’ subsequent evaluations of these follow-up appointments were collected and assessed using separate questionnaires. Results On the basis of data from 52 consultations after 8 withdrawals, it was found that patients were slightly more satisfied with video consultations (mean 1.58, SD 0.643) than with in-clinic consultations (mean 1.64, SD 0.569), although the difference was not statistically significant (P=.69). After excluding video consultations marred by technical problems, no significant difference was found in physician satisfaction between the groups (mean 1.47, SD 0.516 vs mean 1.32, SD 0.557; P=.31). Further analysis indicated that telemedicine can be applied to broader groups of patients and that patients who have prior experience with telemedicine are more willing to use telemedicine for follow-up care. Conclusions Telemedicine can be an alternative and efficient form of follow-up care for patients in orthopedic and trauma surgery in Germany, and it has no significant disadvantages compared with in-person consultations in the clinic. Trial Registration German Clinical Trials Register DRKS00023445; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023445

Analyzing the Effect of Telemedicine on Domains of Quality Through Facilitators and Barriers to Adoption: Systematic Review

“…This theme encompassed anxiety, well-being, stress, loneliness, depression, fear, personal satisfaction, helplessness, rumination, acceptance, suicidal ideation, and resilience. There were 13% (12/92) of instances of improved medical engagement [ 28 , 30 , 32 , 35 , 36 , 40 , 43 , 46 , 48 , 60 ]. This theme included medication compliance, program or treatment adherence, follow-up visits, medical knowledge, and decrease in emergency department visits.…”

COVID-19 related decline in cancer screenings most pronounced for elderly patients and women in Germany: a claims data analysis

“…The use of digital applications could be promoted in the form of apps or telemedicine when suited for the respective examinations. During the COVID-19 pandemic, the use of telemedicine has increased in many areas, such as outpatient care in general medical practices or follow-up care of surgery patients, often providing satisfactory results (Knörr et al 2022 ; Muschol et al 2022 ). Some cancer screenings have also been supported by telehealth services (Price et al 2022 ).…”

Economic and Environmental Impact of Digital Health App Video Consultations in Follow-up Care for Patients in Orthopedic and Trauma Surgery in Germany: Randomized Controlled Trial

“…These questionnaires included questions about the distance between the patients' homes and the clinic, the amount of time spent for the appointment (eg, travel and waiting time), and the potential need to be absent from work to attend the appointment. Further information on the study can be found in a previous publication by Muschol et al [13].…”

“…Various studies show that these goals can be achieved by introducing telemedicine in orthopedic and trauma surgery [6][7][8][9][10][11][12]. In addition, we have extensively analyzed patient and physician satisfaction, as well as quality of care for the study cohort in a previous publication [13]. Second, the costs of the technological infrastructure for telemedicine (eg, for electricity, internet connection, and hardware, such as computers and laptops with cameras and microphones) have to be considered.…”

“…When used for outpatient follow-up care in orthopedic and trauma surgery, for example, video consultations can relieve patients of any restrictions on their mobility or of the need to travel long distances [3][4][5]. Patient satisfaction, physician satisfaction, and clinical outcomes often show comparable results between telemedicine and conventional face-to-face (F2F) examinations in the hospital, demonstrating that video consultations can be a safe and efficient alternative for patient care in orthopedic and trauma surgery [6][7][8][9][10][11][12][13].…”