Telemedicine for preoperative assessment during a COVID-19 pandemic: Recommendations for clinical care

Abstract

Limiting the spread of the disease is key to controlling the COVID-19 pandemic. This includes identifying people who have been exposed to COVID-19, minimizing patient contact, and enforcing strict hygiene measures. To prevent healthcare systems from becoming overburdened, elective and non-urgent medical procedures and treatments have been postponed, and primary health care has broadened to include virtual appointments via telemedicine. Although telemedicine precludes the physical examination of a patient, it allows collection of a range of information prior to a patient's admission, and may therefore be used in preoperative assessment. This new tool can be used to evaluate the severity and progression of the main disease, other comorbidities, and the urgency of the surgical treatment as well as preferencing anesthetic procedures. It can also be used for effective screening and triaging of patients with suspected or established COVID-19, thereby protecting other patients, clinicians and communities alike.

Leveraging Digital Technology to Overcome Barriers in the Prosthetic and Orthotic Industry: Evaluation of its Applicability and Use During the COVID-19 Pandemic

“…Although virtual care would be an excellent solution for patients in remote areas and developing countries, this is also where infrastructure is likely to be poor. These results are aligned to Mihalj et al [ 9 ], who describes five factors that support telemedicine implementation. These include technology (broadband and connection) that must support both the health care provider and patient; secure platform; training to health care providers; patients’ need to be educated on privacy, safety, efficacy, and personal benefits; and cognitive and hearing impairments [ 9 ].…”

“…They have also eliminated distance obstacles from health care [ 8 ]. Digital technology offers possible solutions to patient care during the current pandemic, as health care systems try to limit the spread of COVID-19 by minimizing patient contact and improving hygiene practices [ 9 ].…”

“…Novel technologies like telemedicine may be useful in maintaining social distancing, monitoring a patient’s condition, or detecting infectious diseases, protecting not only patients but also health care providers [ 9 ]. This kind of virtual care can also address several aspects of assessment and care that do not require the time and effort necessary to travel to the P&O or allow care when such travel is not possible or puts patients at risk, such as during a pandemic.…”

Benefits and shortcomings of utilizing telemedicine during the COVID-19 pandemic

“…Clinical encounters are being increasingly transitioned to telemedicine appointments to reduce PPE usage, improve access to care, reduce the burden on health care systems, and minimize the risk of direct person-to-person transmission of COVID-19 between patients as well as to providers. [3][4][5] Nearly all specialties have been forced to embrace virtual appointments, and telemedicine has been useful in evaluating the severity and progression of a disease and other comorbidities, assessing the urgency of surgical treatment, and considering operative and anesthetic procedures for specific patient needs. It can also be used for effective screening and triaging of patients with suspected or established COVID-19, thereby protecting other patients, clinicians, and communities.…”

“…Although telemedicine precludes the physical examination of a patient, it allows collection of a range of information and can be utilized for outpatient visits as well as before surgical admission and may therefore be used in preoperative assessment. [4][5][6][7][8] However, telemedicine is not a perfect solution for many scenarios. In the postoperative patient, there is no physical examination of the operative site, and thus important information may not be obtained.…”