Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

Abstract

Introduction While telemedicine usage has increased due to the COVID-19 pandemic, there remains little consensus about how spine surgeons perceive virtual care. The purpose of this study was to explore international perspectives of spine providers on the challenges and benefits of telemedicine. Methods Responses from 485 members of AO Spine were analyzed, covering provider perceptions of the challenges and benefits of telemedicine. All questions were optional, and blank responses were excluded from analysis. Results The leading challenges reported by surgeons were decreased ability to perform physical examinations (38.6%), possible increased medicolegal exposure (19.3%), and lack of reimbursement parity compared to traditional visits (15.5%). Fewer than 9.0% of respondents experienced technological issues. On average, respondents agreed that telemedicine increases access to care for rural/long-distance patients, provides societal cost savings, and increases patient convenience. Responses were mixed about whether telemedicine leads to greater patient satisfaction. North Americans experienced the most challenges, but also thought telemedicine carried the most benefits, whereas Africans reported the fewest challenges and benefits. Age did not affect responses. Conclusion Spine surgeons are supportive of the benefits of telemedicine, and only a small minority experienced technical issues. The decreased ability to perform the physical examination was the top challenge and remains a major obstacle to virtual care for spine surgeons around the world, although interestingly, 61.4% of providers did not acknowledge this to be a major challenge. Significant groundwork in optimizing remote physical examination maneuvers and achieving legal and reimbursement clarity is necessary for widespread implementation.

The financial implications of telemedicine practice patterns across pediatric surgical specialties

“…Neurosurgery, in particular, may have had a smoother transition to telemedicine due to the existing networks for teleneurology throughout the United States [17] . Another reason for the successful adoption of telemedicine in neurosurgery may be attributed to the finding that the majority of neurosurgeons were not concerned with the limitations imposed by telemedicine on conducting a physical examination virtually [18] . Urology may have had more telehealth encounters in view of higher baseline use prior to the pandemic.…”

Telemedicine use by neurosurgeons due to the COVID-19 related lockdown

“…As the use of telemedicine has increased massively during the COVID-19 pandemic, so has the research on the use of telemedicine ( Tandon et al, 2021 ; Shafi et al, 2021 ; Swiatek et al, 2021 ; Ryu et al, 2021 ; Zengin et al, 2021 ; Lovecchio et al, 2020 ; Mohanty et al, 2020 ; Riew et al, 2021 ) . Table 5 gives an overview of eight published survey results on the use of telemedicine during the COVID-19 pandemic among neurological and spine surgeons.…”

Reflections on the future of telemedicine and virtual spinal clinics in the post COVID-19 era

“…Another international study, involving 485 spine surgeons, assessed the perception of virtual clinics in spinal practice and the main challenges involved; 39% of participants reported that the main challenge was the limited ability to perform a physical examination, followed by concerns of medico-legal implications (19%). Surprisingly, only 9% of participants reported problems with technology ( Riew et al, 2021a ).…”