Implementation of vascular surgery teleconsultation during the COVID-19 pandemic: Insights from the outpatient vascular clinics in a tertiary care hospital in Qatar

Abstract

Background The COVID-19 pandemic has sparked a surge in the use of virtual communication tools for delivering clinical services for many non-urgent medical needs allowing telehealth or telemedicine, to become an almost inevitable part of the patient care. However, most of patients with vascular disease may require face-to-face interaction and are at risk of worse outcomes if not managed in timely manner. Objective We aimed to describe the utilization of telemedicine services in the outpatient vascular surgery clinics in a tertiary hospital. Methods A retrospective analysis of data on all vascular outpatient encounters during 2019 and 2020 was conducted and compared to reflect the pattern of practice prior to and during the COVID-19 pandemic. Results The study showed that 61% of the total patient encounters in 2020 were reported through teleconsultation. Females were the majority of patients who sought the virtual vascular care. Consultations for the new cases decreased from 29% to 26% whereas, the follow-up cases increased from 71% to 74% in 2020 (p = 0.001). The number of procedures performed in the vascular outpatient clinics decreased by 46% in 2020 when compared to 2019. This decrease in procedures was more evident in the duration from February 2020 to April 2020 in which the procedures decreased by 97%. The proportion of procedures represented 22.6% of the total encounters in 2019 and 10.5% of the encounters during 2020, (p = 0.001). Conclusions Teleconsultation, along with supporting practice guidelines, can be used to maximize the efficiency of care in vascular surgery patients during the pandemic and beyond. Adoption of the ‘hybrid care’ which combines both virtual and in-person services as an ongoing practice requires evidence obtained through audits and studies on patients and healthcare providers levels. It is essential to establish a clear practice that ensures patient’s needs.

Telemedicine in Vascular Surgery During COVID-19 Pandemic: A Systematic Review and Narrative Synthesis

“…After review, 12 studies were included, reporting data on 27,307 patients12–23( Table 1 ). One study 14 evaluating teleconsultation utilization rates reported data on 23,894 patients and was the largest study by far. Eleven studies were retrospective cohort studies12–19,21–23, and one was a case series 20 .…”

“…The other four studies were undertaken in Qatar, Australia, Colombia and China14,15,19,22. Eight studies looked at data collected during the early period of the COVID-19 pandemic (between March 2020 to September 2020) 12 , 15 , 16 , 17 , 20 , 21 , 22 , 23 , one study looked at data collected between April and June 2021 19 , and two studies looked at data collected throughout the pandemic 14 , 18 .…”

“…Five studies reported the usage of telemedicine during the pandemic, ranging from 12.6-61% of all outpatient appointment encounters during the study period 12 , 14 , 15 , 19 , 23 . Four studies looked at usage during the early part of the pandemic (all during 2020) 12 , 14 , 15 , 23 .…”

“…Five studies reported the usage of telemedicine during the pandemic, ranging from 12.6-61% of all outpatient appointment encounters during the study period 12 , 14 , 15 , 19 , 23 . Four studies looked at usage during the early part of the pandemic (all during 2020) 12 , 14 , 15 , 23 . Al-Thani, et al reported that in 2020, 61% of all outpatient encounters with a vascular surgeon used telemedicine compared to 0% before the pandemic 14 , whereas Erben, et al reported only 12.6% of 6262 patients encounters were virtual 23 .…”

“…Four studies looked at usage during the early part of the pandemic (all during 2020) 12 , 14 , 15 , 23 . Al-Thani, et al reported that in 2020, 61% of all outpatient encounters with a vascular surgeon used telemedicine compared to 0% before the pandemic 14 , whereas Erben, et al reported only 12.6% of 6262 patients encounters were virtual 23 . Contractor, et al reported that 178 of the 333 (53.5%) outpatient consultations undertaken in their institution were teleconsultations 12 .…”