Development, Implementation, and Evaluation of a Telemedicine Preoperative Evaluation Initiative at a Major Academic Medical Center

Kamdar, Nirav; Huverserian, Ari; Jalilian, Laleh; Thi, William J.; Duval, Victor; Beck, Lauren; Brooker, Lindsay; Grogan, Tristan; Lin, Anne; Cannesson, Maxime

doi:10.1213/ane.0000000000005208

Cited by 81 publications

(112 citation statements)

References 14 publications

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“…Telehealth eliminates travel time and the stress of finding parking and clinic location; improves access to care, especially for patients in rural areas; and allows family members to join remotely. An added benefit to telehealth is the potential for patient cost savings, as remote delivery of care would eliminate costs associated with travel, parking, and/or need to take time off from work 70,71 …”

Section: Discussionmentioning

confidence: 99%

Performing nutrition assessment remotely via telehealth

et al. 2021

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Performing nutrition assessment remotely via telehealth is a topic of significant interest given the global pandemic in 2020 that has necessitated physical distancing and virtual communications. This review presents an evidence‐based approach to conducting nutrition assessments remotely. The authors present suggestions for adaptations that can be used to perform a remote nutrition‐focused physical exam. Direct‐to‐consumer technologies that can be used in remote nutrition assessment are discussed and compared. Practice tips for conducting a telehealth visit are also presented. The aim of this publication is to provide interdisciplinary clinicians a set of guidelines and best practices for performing nutrition assessments in the era of telehealth.

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Section: Discussionmentioning

confidence: 99%

Performing nutrition assessment remotely via telehealth

et al. 2021

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“…This study was the first to demonstrate feasibility and benefits in a large urban metropolis as prior studies of telemedicine in anesthesiology dating to 2004 1 were focused on rural areas with limited health care access. 11 Our study similarly was retrospective and took place within an urban metropolis.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical and anesthesiology departments at UCLA Health are considerably larger than Moffitt Cancer Center, covering 90 operating sites and 60 000 procedures annually compared with 21 sites and greater than 15 000 procedures annually at Moffitt. 11 Further, the Moffitt patient population differs from the UCLA Health patient population as they are all oncology patients with unique needs who tend to be overtaxed by the health care system. The current study is the first to evaluate feasibility of preoperative telemedicine evaluations specifically for oncologic surgical patients at a freestanding NCI-designated comprehensive cancer care center (one of fifty-one in the country).…”

Section: Discussionmentioning

confidence: 99%

“… 2 Subsequent studies have likewise found high patient and provider satisfaction with no increase in day-of-surgery (DOS) cancellations when using telemedicine for preoperative assessment. 3 - 12 Furthermore, patients who underwent telemedicine evaluation were found to save significant time, distance, and cost associated with travel and in some cases, a shorter duration of the evaluation itself. 4 , 6 , 9 , 13 These savings were found both in rural and metropolitan settings.…”

Section: Introductionmentioning

confidence: 99%

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A Retrospective Analysis of Patients Undergoing Telemedicine Evaluation in the PreAnesthesia Testing Clinic at H. Lee Moffitt Cancer Center

et al. 2021

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Background Telemedicine for preanesthesia evaluation can decrease access disparities by minimizing commuting, time off work, and lifestyle disruptions from frequent medical visits. We report our experience with the first 120 patients undergoing telemedicine preanesthesia evaluation at Moffitt Cancer Center. Methods This is a retrospective analysis of 120 patients seen via telemedicine for preanesthesia evaluation compared with an in-person cohort meeting telemedicine criteria had it been available. Telemedicine was conducted from our clinic to a patient’s remote location using video conferencing. Clinic criteria were revised to create a tier of eligible patients based on published guidelines and anesthesiologist consensus. Results Day-of-surgery cancellation rate was 1.67% in the telemedicine versus 0% in the in-person cohort. The two telemedicine group cancellations were unrelated to medical workup, and cancellation rate between the groups was not statistically significant ( P = .49). Median round trip distance and time saved by the telemedicine group was 80 miles [range 4; 1180] and 121 minutes [range 16; 1034]. Using the federal mileage rate, the median cost savings was $46 [range $2.30; 678.50] per patient. Patients were similar in gender and race in both groups ( P = .23 and .75, respectively), but the in-person cohort was older and had higher American Society of Anesthesiologists physical status classification ( P = .0003). Conclusions Telemedicine preanesthesia evaluation results in time, distance, and financial savings without increased day-of-surgery cancellations. This is useful in cancer patients who travel significant distances to specialty centers and have a high frequency of health care visits. American Society of Anesthesiologists Physical Status classification and age differences between cohorts indicate possible patient or provider selection bias. Randomized controlled trials will aid in further exploring this technology.

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“…Several surgical studies have evaluated preoperative consultations using different forms of telemedicine. Kamdar et al [21] examined the development, implementation, and evaluation of a telemedicine initiative for preoperative anesthetic evaluation. Over 2 years, 419 patients were scheduled for surgery via telemedicine and 1,785 patients were evaluated in-person, with day-of-surgery cancellation rates of 2.95% and 3.23%, respectively.…”

Section: Rise Of Telemedicine During the Pandemicmentioning

confidence: 99%

A look to the future: Pandemic-induced digital technologies in vascular surgery

Lin

Welle

Ding

et al. 2021

Seminars in Vascular Surgery

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Like many areas of medicine, vascular surgery has been transformed by the COVID-19 (coronavirus disease 2019) pandemic. Public health precautions to minimize disease transmission have led to reduced attendance at hospitals and clinics in elective and emergency settings; fewer face-to-face and hands-on clinical interactions; and increased reliance on telemedicine, virtual attendance, investigations, and digital therapeutics. However, a “silver lining” to the COVID-19 pandemic may be the mainstream acceptance and acceleration of telemedicine, remote monitoring, digital health technology, and three-dimensional technologies, such as three-dimensional printing and virtual reality, by connecting health care providers to patients in a safe, reliable, and timely manner, and supplanting face-to-face surgical simulation and training. This review explores the impact of these changes in the delivery of vascular surgical care.

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Development, Implementation, and Evaluation of a Telemedicine Preoperative Evaluation Initiative at a Major Academic Medical Center

Abstract: Supplemental Digital Content is available in the text.

Cited by 81 publications

References 14 publications

Performing nutrition assessment remotely via telehealth

Performing nutrition assessment remotely via telehealth

A Retrospective Analysis of Patients Undergoing Telemedicine Evaluation in the PreAnesthesia Testing Clinic at H. Lee Moffitt Cancer Center

A look to the future: Pandemic-induced digital technologies in vascular surgery

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