Telemedicine for Surgical Consultations – Pandemic Response or Here to Stay?

Abstract

This study aims to determine the public's perception of telemedicine surgical consultations, during the COVID-19 pandemic and beyond. Summary Background Data: With rapid expansion and uptake of telemedicine during the pandemic, many have posited that virtual visits will endure even as in-person visits are reinstated. The public's perception of telemedicine for an initial surgical consultation has not been previously studied. Methods: A 43-question survey assessed respondents' attitudes toward telemedicine for initial consultations with surgeons, both in the context of COVID-19 and during ''normal circumstances.'' Participants were recruited through Amazon Mechanical Turk, an online crowd-sourcing marketplace. Results: Based on 1827 analyzable responses, we found that a majority (86%) of respondents reported being satisfied (either extremely or somewhat) with telemedicine encounters. Interestingly, preference for in-person versus virtual surgical consultation reflected access to care, with preference for telemedicine decreasing from 72% to 33% when COVID-related social distancing ends. Preferences for virtual visits decreased with increasing complexity of the surgical intervention, even during the pandemic. A majority felt that ''establishing trust and comfort'' was best accomplished in person, and the vast majority felt it was important to meet their surgeons before the day of surgery. Conclusions: The public views telemedicine as an acceptable substitute for in-person visits, especially during the pandemic. However, it seems that an inperson interaction is still preferred when possible for surgical consultations. If telemedicine services are to persist beyond social distancing, further exploration of its impact on the patient-surgeon relationship will be needed.

Surgery for non-Covid-19 patients during the pandemic

“…Several studies have reported interesting perspectives of telemedicine in the surgical context, especially due to economic benefit, reduced missed work and reduced trips to hospital [ 9 – 11 ]. A survey on public’s perception of telemedicine showed that it was an acceptable substitute for in-person visits, especially during the pandemic [ 10 ]. It must be mentioned too that some providers worked in disciplines that were not their areas and were probably less comfortable in.…”

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

“…In the surgical field, recent evidence suggests high enthusiasm for telemedicine from both patients and providers. However, concerns arise in respect to the quality of care delivered and the safety of this practice for postoperative care clinics [ 9 ].…”

“…Previous experiences with telemedicine in postoperative care have demonstrated safe and effective wound care, postoperative patient education and even ileostomy output management [ 10 , 11 ]. However, most patients and providers prefer in-person postoperative visits during normal times [ 9 ]. COVID-19 social distancing protocols have encouraged many patients to seek remote medical attention even after major surgery.…”

Surgery Provider Perceptions on Telehealth Visits During the COVID-19 Pandemic: Room for Improvement

“…As COVID-19 emerged, both providers and patients, regardless of their prior training or comfort with telehealth, have been forced to provide or receive care remotely whenever possible. Sorensen et al 12 recently conducted a public survey to understand current perceptions on virtual care during the COVID-19 pandemic. The authors identified a high degree of public satisfaction with telehealth visits, but noted that the current elevated preference for virtual care would decrease once socialdistancing guidelines loosen.…”