Multicenter Evaluation of Telehealth Utilization in Hip and Knee Arthroplasty Before and for One Year During the COVID-19 Pandemic

Abstract

Background The Coronavirus Disease 2019 (COVID-19) pandemic has led to an increase in telehealth utilization across healthcare. It is unknown if telehealth use among hip and knee arthroplasty clinics has remained an important healthcare delivery platform. The purpose of the present study was to analyze telehealth utilization prior to and for one-year during the pandemic among four, varied hip and knee arthroplasty clinics. Methods Retrospective data was available from four, regionally diverse hip and knee arthroplasty centers. Data on volume of patient visits, demographics, visit types (new visit, follow-up, postoperative visit, other), visit modality (in-person, telehealth, telephone) was available from January 2020 through April 2021. Data from the centers was analyzed as a total and separately, using Chi-squared and Fisher exact tests. Results Among the four centers, there were 296,540 hip and knee arthroplasty outpatient clinic visits between January 2020 through April 2021. Of those, 15,240 (5%) were telehealth visits. Prior to March 2020, less than 0.1% of visits across centers occurred over telehealth. The highest utilization of telehealth visits occurred in March 2020 (>55%) and April 2020 (>25%). From August 2020 until April 2021, telehealth visits accounted for 2-3% of total visits. Younger patients (<50 years old) were most likely to utilize telehealth. Follow-up and postoperative were the most likely telehealth visits. Conclusion Telehealth utilization peaked during March and April of 2020 and has since reverted to near pre-pandemic levels. Younger patients and lower complexity visits such as postoperative or follow-up visits are more likely to utilize telehealth.

Reduction in hospital length of stay and increased utilization of telemedicine during the “return-to-normal” period of the COVID-19 pandemic does not adversely influence early clinical outcomes in patients undergoing total hip replacement: a case-control study

“…Orthopedic surgeons became early adopters of telehealth services, with over 80% of orthopedic surgery departments implementing and utilizing these telehealth services ( 20 ), which had previously accounted for less than 1% of all patient visits in the United States pre-pandemic ( 21 ). In a recent study by Bini et al, telehealth services peaked during the height of the early pandemic and were more likely to be utilized for postoperative follow-up visits ( 22 ). The increased utilization of telehealth services for postoperative visits is likely multifactorial and may be explained by its widespread adoption, the sudden ability to receive reimbursement for the telehealth visit, and increased necessity for management of postoperative issues and rehabilitation during a time when social distancing was paramount.…”

The Use of Digital Health Services Among Patients and Citizens Living at Home: Scoping Review

“…In addition to the concept of video visits and videoconferencing, expressions such as video consultation and video encounter were used when patients had consultations with health care professionals via a video connection. In addition, telehealth visits [ 72 , 119 ], platforms [ 73 ], eHealth [ 117 ], telephone (or voice) calls [ 45 , 52 , 53 , 63 , 65 , 68 , 73 - 78 , 92 - 98 , 100 , 101 , 118 , 127 , 128 ], text messages [ 90 ], and mobile apps [ 118 ] were mentioned as means for consultation. Looi et al [ 93 , 94 ] found that during the second and third quarters of 2021, the telephone was mostly used for telehealth visits in private psychiatry practice in Australia.…”

“…The use of or the possibility for video consultation is especially important for rural and other areas with long distances, though infrastructural or cultural issues may currently prevent or delay the use of digital services in some locations [ 67 , 84 , 108 , 119 ]. According to the results, telephone calls were still used frequently for contacting patients [ 45 , 52 , 53 , 63 , 65 , 68 , 73 , 74 , 92 - 97 , 127 , 128 ]. In some studies, most consultations were done over the phone [ 74 , 93 , 94 , 128 ].…”

“…In this sense, a limitation of this study is that it covered only health care services, as health can be seen (as defined by WHO) as a sum of the physical, mental, and social aspects of one’s well-being. In some papers, issues such as drug and other substance use disorders or alcohol abuse were discussed [ 72 , 73 ]. In the northern European context, these belong primarily within the purview of social services.…”

The Use of Digital Health Services Among Patients and Citizens Living at Home: Scoping Review (Preprint)

“…In addition to the concept of video visits and videoconferencing, expressions such as video consultation and video encounter were used when patients had consultations with health care professionals via a video connection. In addition, telehealth visits [72,119], platforms [73], eHealth [117], telephone (or voice) calls [45,52,53,63,65,68,[73][74][75][76][77][78][92][93][94][95][96][97][98]100,101,118,127,128], text messages [90], and mobile apps [118] were mentioned as means for consultation. Looi et al [93,94] found that during the second and third quarters of 2021, the telephone was mostly used for telehealth visits in private psychiatry practice in Australia.…”