Digital Health Care, Telemedicine, and Medicolegal Issues in Orthopedics: A Review

Ferorelli, Davide; Moretti, Luigi; Benevento, Marcello; Mastrapasqua, Maurizio; Telegrafo, Michele; Solarino, Biagio; Dell’Erba, Alessandro; Bizzoca, Davide; Moretti, Biagio

doi:10.3390/ijerph192315653

Cited by 6 publications

(3 citation statements)

References 41 publications

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“…Hence, we should prioritize addressing medical errors by combining the age and affected sites of patients in clinical practice. Additionally, the COVID-19 pandemic has given to the spread of telemedicine in the orthopaedic field ( 37 ), which might be an effective approach to improve the patient safety in the orthopaedic specialty. Previous interventions might be less effective, as they are slightly generic and exceedingly concentrated on the operation stage.…”

Section: Discussionmentioning

confidence: 99%

Medical errors, affected sites, and adverse consequences among patients in the orthopaedic department: Does age matter?

Liu,

Cheng,

Yang

et al. 2024

Front. Public Health

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BackgroundOrthopaedics have become the focus of research on patient safety due to the high incidence of medical errors. Previous studies were based on all orthopaedic patients and rarely conducted empirical analyses from the perspective of age. This study aimed to fill the academic gap in the age variable by comparing medical errors, affected sites, and adverse consequences in orthopaedic patients.MethodsThis retrospective study included 329 litigation claims against orthopaedists using data from China Judgments Online. First, we performed computer crawling and screened 5,237 litigation documents using keywords, including medical errors. Second, 2,536 samples were retained through systematic random sampling, and 549 irrelevant cases were deleted after manual reading. Finally, three clinicians from different medical departments selected 329 incidents related to orthopaedics for further analysis, according to the description of the lawsuits. Three other professional orthopaedists evaluated the patients’ ages, affected sites of medical errors, and adverse consequences.ResultsThe greatest number of medical errors was observed in the joints (30.43%) for all orthopaedic patients. However, adult patients (aged 18–60 years) were most susceptible to errors in the extremities (30.42%). A higher rate of complications was associated with a higher rate of morbidity/mortality for the corresponding patients. Medical errors correlated with complications occurred in the following sites: joints (15.38%), extremities (12.50%), spine (16.95%), multiple sites (15.38%), and hands and feet (14.81%). In addition to surgical errors, over 10% of all orthopaedic patients experienced missed diagnoses. The incidence of insufficient adherence to informed consent obligations was 13.5% among adult patients and was much higher in paediatric and older adults patients. When orthopaedic patients suffered from medical technical errors, iatrogenic mortality/morbidity would decrease by 0.3% for one unit increase in age.ConclusionDividing patients into different ages demonstrated diverse results in terms of medical errors and affected sites. Negligence in diagnosis and examination can be fatal factors that endanger safety, and complications may cause morbidity/mortality. When patients suffered from technical errors, age is inversely proportional to mortality/morbidity. Special attention needs to be paid to technical errors in the younger older adults population (60–64 years old), which has inspired implications in promoting aging and public health.

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Section: Discussionmentioning

confidence: 99%

Medical errors, affected sites, and adverse consequences among patients in the orthopaedic department: Does age matter?

Liu,

Cheng,

Yang

et al. 2024

Front. Public Health

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“…The pandemic has also triggered efforts to increase health literacy, which positively influences the willingness to share PHI ( 40 ). Owing to the spread of COVID-19, many health providers adopted telemedicine, which allowed the delivery of health care services without any close contact ( 41 , 42 ). Whether and how telemedicine may have provided a vast amount of digital PHI and influenced the likelihood of sharing PHI remain unclear and deserve a deeper analysis.…”

Section: Discussionmentioning

confidence: 99%

Measuring the willingness to share personal health information: a systematic review

Benevento

Mandarelli

Carravetta

et al. 2023

Front. Public Health

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BackgroundIn the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the determinants and describe the measurement of the willingness to disclose personal health information.MethodsThe study conducted a systematic review of articles assessing willingness to share personal health information as a primary or secondary outcome. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. English and Italian peer-reviewed research articles were included with no restrictions for publication years. Findings were narratively synthesized.ResultsThe search strategy found 1,087 papers, 89 of which passed the screening for title and abstract and the full-text assessment.ConclusionNo validated measurement tool has been developed for willingness to share personal health information. The reviewed papers measured it through surveys, interviews, and questionnaires, which were mutually incomparable. The secondary use of data was the most important determinant of willingness to share, whereas clinical and socioeconomic variables had a slight effect. The main concern discouraging data sharing was privacy, although good data anonymization and the high perceived benefits of sharing may overcome this issue.

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“…Other recent studies have shown that in-person clinical examination is necessary to confirm suspected instability of the shoulder [39][40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Bari Shoulder Telemedicine Examination Protocol (B-STEP): A Standard Protocol for Personalized Remote Shoulder Examination

Moretti

Bizzoca

Farì

et al. 2023

JPM

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The COVID-19 pandemic drastically changed many aspects of the traditional functioning of health systems all around the world. In Italy, as reported by the CIO, compared to the previous year, there was a significant reduction in 2020 in overall outpatient activities by up to 75%. These data support the need for telemedicine, which represents a current challenge and can no longer be postponed in the future. This study aims to elaborate on a possible model for remote shoulder examination based on traditional tests to improve the quality of telemedicine in orthopedic and rehabilitation. Between May 2020 and November 2020, ten orthopedic surgeons individually examined six patients with a known shoulder disorder, both in hospital and via webcam according to the previously shared protocol (B-STEP). According to the 10 observers, completing 100% of the ASES score and at least 87.5% of the Constant score is possible. Shoulder ROM and many specific tests are also reproducible via webcam, but with less sensitivity, according to the subjective opinion of observers. The B-STEP is a useful protocol for the standardization of the objective examination of the shoulder via webcam. Further studies are necessary to determine if the B-STEP protocol is useful for diagnosing pathology in unknown patients and evaluating its sensitivity and specificity for each pathology.

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Digital Health Care, Telemedicine, and Medicolegal Issues in Orthopedics: A Review

Cited by 6 publications

References 41 publications

Medical errors, affected sites, and adverse consequences among patients in the orthopaedic department: Does age matter?

Medical errors, affected sites, and adverse consequences among patients in the orthopaedic department: Does age matter?

Measuring the willingness to share personal health information: a systematic review

Bari Shoulder Telemedicine Examination Protocol (B-STEP): A Standard Protocol for Personalized Remote Shoulder Examination

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