Feasibility of Rapid Development and Deployment of a Telemedicine Program in a Foot and Ankle Orthopedic Practice

Abstract

Background: A lack of access to care is predictably associated with negative outcomes in foot and ankle surgery. Despite recent advances in telecommunication technologies, the field of orthopedics has been slow to adopt these resources in offsetting barriers to care. The COVID-19 pandemic has forced departments to change their clinical approach, lending unprecedented opportunity to better understand how telehealth may bridge this care gap in foot and ankle practices. The purpose of this study was to assess patient-reported outcomes of telemedicine encounters, including comfort and patient satisfaction. Our hypothesis was that patients would be significantly less satisfied with telemedicine when compared with in-office appointments for all nonemergency visit types. Methods: Telemedicine satisfaction was assessed via phone survey with a modified 1 to 5 Likert scale. Patients who had completed a telemedicine visit between April 13, 2020, and June 19, 2020, were eligible to participate. Patient demographics were recorded, and data were analyzed using paired and independent t tests for parametric continuous data and Fisher’s exact and chi-square tests for noncontinuous data. A total of 216 patients completed the telemedicine questionnaire. Results: The overall mean satisfaction for telemedicine visits (4.7) was significantly lower than that for in-office visits (4.9) ( P < .001). However, the majority (90.3%) of patients reported they would use telemedicine again in the future. When compared, patients seeking fracture care had significantly higher telemedicine satisfaction (4.9, n = 38) than those receiving nonfracture care (4.6, n = 178) ( P = .001), and those greater than 50 miles from the clinic had higher satisfaction (5.0, n = 14) than patients living within 50 miles of the clinic (4.7, n = 202) ( P < .001). Conclusion: Patients were more satisfied with their in-office clinic visit than telemedicine, although the vast majority of patients endorsed a willingness to utilize telemedicine in the future. Patients with trauma and greater barriers to foot and ankle care were more satisfied with their telemedicine visits. Level of Evidence: Level III, retrospective cohort study.

Virtual postoperative visits following robotic gynecologic surgery: a study of patient satisfaction, safety, and feasibility

“…Telehealth visits following minimally invasive gynecologic procedures appear to be safe and feasible, and are associated with a high level of patient satisfaction. We were able to demonstrate that patients were highly satisfied with their experience, similar to studies conducted in other surgical specialties [ 2 , 3 ]. Furthermore, we did not find that postoperative telehealth visits led to a delay in the diagnosis of postoperative complications or an increased demand for in-person visits.…”

“…Due to social distancing regulations, healthcare providers have adopted widespread use of telehealth visits [ 1 ]. Surgical specialties have already demonstrated successful implementation of telehealth visits into the spectrum of their care [ 2 , 3 ]. These data highlight the feasibility and patient satisfaction with virtual visits during a pandemic.…”

Telemedicine trends in orthopaedics and trauma during the COVID-19 pandemic: A bibliometric analysis and review

“…Fifty-nine articles met the inclusion criteria and were considered for the analysis. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 The excluded thirty-four papers were editorials, letters, duplicate entries, and articles with no discussion on telemedicine even in the full text ( Figure 1 ). The monthly contributions trend of the orthopaedic telemedicine-related articles is shown in Figure 2 .…”

“… 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 Telemedicine can address the general and specialised needs of osteoporotic patients, paediatric deformities, fracture patients, and sports injuries. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 High patient and doctor satisfaction has been recorded with telemedicine. 26 It is found to be helpful in decision-making and telephone-based follow-up care.…”

Analysis of Maxillofacial Traumas at Thrace Region amid COVID-19 Pandemic

“…Telemedicine and virtual consultation methods are also used successfully in orthopedics, which is a branch that frequently uses imaging methods in patient treatment 3,11 . In randomized controlled studies conducted within the scope of this branch, it has been shown that these methods can be used safely in selected patients 4,12 . In order to be used in a wider context, the success of this approach should also be demonstrated by economic and patient satisfaction-based studies.…”