Implementation of a virtual vascular clinic with point-of-care ultrasound in an integrated health care system

Lin, Judith C.; Crutchfield, Janelle M.; Zurawski, Dana K.; Stevens, Caitlin

doi:10.1016/j.jvs.2017.11.070

Cited by 20 publications

(26 citation statements)

References 12 publications

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“…In another instance, videoconferencing was used for the management of patients at home after carotid endarterectomy procedures, which allowed for early patient discharge 61 . Preoperative management and referral of vascular surgery candidates using TM has also been tested, involving live consultations with off‐site specialists, however, this usually requires patients to be physically present at locations which have access to trained staff and diagnostic facilities 62‐64 …”

Section: Introduction To Covid‐19mentioning

confidence: 99%

“…61 Preoperative management and referral of vascular surgery candidates using TM has also been tested, involving live consultations with off-site specialists, however, this usually requires patients to be physically present at locations which have access to trained staff and diagnostic facilities. [62][63][64] 1.5 | TM cannot always be relied upon A further limitation of TM is that preoperative evaluations are difficult to perform and a full physical examination cannot be conducted over a digital platform. 66 Regardless of these issues, TM is seen to be just as effective as face-to-face consultations 67 when it comes to patient satisfaction and clinical effectiveness regarding triaging, straightforward diagnosis, and postoperative rehabilitation.…”

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confidence: 99%

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Telemedicine in cardiovascular surgery during COVID‐19 pandemic: A systematic review and our experience

et al. 2020

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Objective The SAR‐COV‐2 pandemic has had an unprecedented effect on the UK's healthcare systems. To reduce spread of the virus, elective treatments and surgeries have been postponed or canceled. There has been a rise in the use of telemedicine (TM) as an alternative way to carry outpatient consultations. This systematic review aims to evaluate the extent to which TM may be able to support cardiac and vascular surgery patients in the COVID‐19 era. Methods We looked into how TM can support the management of patients via triaging, preoperative, and postoperative care. Evaluations targeted the clinical effectiveness of common TM methods and the feasibility of applying those methods in the UK during this pandemic. Results Several studies have published their evidence on the benefit of TM and its benefit during COVID‐19, the data related to cardiovascular surgery and how this will impact future practice of this speciality is emerging and yet larger studies with appropriate timing of outcomes to be published. Conclusion Overall, the use of virtual consultations and remote monitoring is feasible and best placed to support these patients via triaging and postoperative monitoring. However, TM can be limited by the need of sophisticated technological requirement and patients’ educational and know‐how computer literacy level.

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Section: Introduction To Covid‐19mentioning

confidence: 99%

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confidence: 99%

Telemedicine in cardiovascular surgery during COVID‐19 pandemic: A systematic review and our experience

et al. 2020

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“…Description of the Virtual Vascular Clinic and the clinic workflow diagram have been published previously. 7 Briefly, the study group included patients older than 20 years with CVD receiving virtual care. The decision for participating in the virtual care programme depended on the patients and/or their provider.…”

Section: Methodsmentioning

confidence: 99%

“…6 We have also published the safety and feasibility of synchronous telemedicine with point-of-care ultrasound in evaluating common vascular conditions, which allows more access for patients who require additional care while decreasing overall in-person clinic utilisation. 7 Clinical outcomes of synchronous virtual visits have not been analysed with face-to-face patient encounters for CVD. Based on our previous reports, we hypothesise that patients with varicose veins may be managed effectively via telemedicine and traditional clinic.…”

Section: Introductionmentioning

confidence: 99%

Comparison of virtual visit versus traditional clinic for management of varicose veins

et al. 2018

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Introduction The objective of this study is to compare the clinical outcomes of patients with varicose veins managed in the telemedicine clinic and traditional clinic. Methods Retrospective analysis of all vein procedures in the institutional Vascular Quality Initiative Varicose Vein Registry (VQI VVR) was performed from January 2015 to August 2017. Patients were divided into two groups: Telemedicine versus Traditional Clinic. Comparison data included patient demographics, past medical history, clinical outcomes, patient-reported outcomes and postoperative complications. Statistical testing included chi-square test for categorical variables and student t-test for continuous variables using the SPSS statistical software. Results A total of 1034 varicose vein procedures were performed during the 31-month study period. There were 75 virtual encounters in the Telemedicine Clinic (Group A) and 959 face-to-face encounters in the Traditional Clinic (Group B). Most of the demographics characteristics were clinically similar in both groups. Comparing Group A and Group B, there were no differences in age, sex, race and body mass index. Early 3-month follow up was 100% in Group A and 90.7% in Group B. Both groups had low complication rates of haematoma (1.3% vs 0.3%, p = 0.884), paraesthesia (1.3% vs 0.6%, p = 0.767) and recanalisation (1.3% vs 4.0%, p = 0.383) during the early follow up period. Discussion Synchronous virtual visits for patient care are feasible for the management of chronic venous disease. Patients with varicose veins who choose to undergo telemedicine evaluations have similar pre-operative demographics, clinical classification and patient outcomes.

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“…Although telemedicine was shown to be effective in reducing waiting time, travel distance and costs 1 , 2 , 3 and demonstrated good results when used in surgical fields, 4 , 5 , 6 , 7 it has never been implemented as widely as it is today.…”

mentioning

confidence: 99%

Argentine experience with telemedicine for venous care during the COVID-19 pandemic

Santos

Loson

Plazzotta

et al. 2020

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Implementation of a virtual vascular clinic with point-of-care ultrasound in an integrated health care system

Cited by 20 publications

References 12 publications

Telemedicine in cardiovascular surgery during COVID‐19 pandemic: A systematic review and our experience

Telemedicine in cardiovascular surgery during COVID‐19 pandemic: A systematic review and our experience

Comparison of virtual visit versus traditional clinic for management of varicose veins

Argentine experience with telemedicine for venous care during the COVID-19 pandemic

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