Telemedicine in Cleft Care

Abstract

Video teleconferencing can be used to provide comprehensive regional and international cleft care to facilitate initial evaluations and consistent follow-up. This technology can alleviate the travel burden on families and cleft care providers practicing over a large geographic radius.

Current Use of Telemedicine for Post-Discharge Surgical Care: A Systematic Review

“…56,57 Seven studies examined the potential for replacing follow-up clinic visits with a telephone call 47,54 or an online videoconference, either from the patient’s home 45,48,49 or from an affiliated remote clinic site. 50,52,53 Among the studies using telemedicine for ongoing monitoring, patients’ reported symptoms were collected either by automated telephone survey 43 or videophone with live patient interviews. 51 Specific objective clinical data were collected using text messages for daily surgical drain output, 55 electronic transmission of home spirometry results, 58 and more complex multi-modal monitoring of symptoms, blood pressure, and medication adherence.…”

“…As stated by Pirris and coauthors, 56 the “absence of professional and legal guidelines regarding the safe use of mobile camera phones in a clinical setting may make formal adoption of the practice difficult and expose its users to medico-legal pitfalls.” Indeed, many of the studies included in this review used already-established technologies (eg Skype, online videoconferencing platforms, SMS text messaging, etc), with no modifications to make them compliant with HIPAA or otherwise ensure patient privacy and protection. Only 1 study 53 was explicit in using a HIPAA-compliant videoconferencing platform. In a review of the 10 most commonly used voice over internet protocol (VOIP) videoconferencing software, Watzlaf and associates 69 found frequent and widespread security vulnerabilities in nearly every platform studied.…”

“…Telemedicine programs have the potential to create significant cost savings to patients and health systems, but they can be costly to establish. Costa and colleagues 53 estimated the cost of equipping a remote site to perform videoconference clinic visits at $8,000 to $11,000. Before such expenses are made, larger and more rigorous studies are needed to establish the benefits of telemedicine and to ensure that postoperative complications are detected in a timely and appropriate way.…”

“…1, Sathiyakumar et al 48 ; 2, Viers et al 45 ; 3, Urquhart et al 50 ; 4, Eisenberg et al 54 ; 5, Stypulkowski et al 62 ; 6, Hwa et al 47 ; 7, Costa et al 53 ; 8, Canon et al 52 …”

Transitioning Multidisciplinary Craniofacial Care to Telehealth during the COVID-19 Pandemic: A Single Center Experience

“…Prior studies have demonstrated the efficacy of telehealth in cleft care, and our experience here shows that interdisciplinary craniofacial care can be delivered virtually. 6 , 7 This experience has led us to re-envision how ideal craniofacial clinics will be structured in the future. In our experience, many evaluations can be accomplished over video, especially annual follow-up visits unlikely to require major intervention.…”