Telemedicine in orthopaedic surgery during the COVID-19 pandemic

Abstract

Aims This study assesses patient barriers to successful telemedicine care in orthopaedic practices in a large academic practice in the COVID-19 era. Methods In all, 381 patients scheduled for telemedicine visits with three orthopaedic surgeons in a large academic practice from 1 April 2020 to 12 June 2020 were asked to participate in a telephone survey using a standardized Institutional Review Board-approved script. An unsuccessful telemedicine visit was defined as patient-reported difficulty of use or reported dissatisfaction with teleconferencing. Patient barriers were defined as explicitly reported barriers of unsatisfactory visit using a process-based satisfaction metric. Statistical analyses were conducted using analysis of variances (ANOVAs), ranked ANOVAs, post-hoc pairwise testing, and chi-squared independent analysis with 95% confidence interval. Results The survey response rate was 39.9% (n = 152). The mean age of patients was 51.1 years (17 to 85), and 55 patients (38%) were male. Of 146 respondents with completion of survey, 27 (18.5%) reported a barrier to completing their telemedicine visit. The majority of patients were satisfied with using telemedicine for their orthopaedic appointment (88.8%), and found the experience to be easy (86.6%). Patient-reported barriers included lack of proper equipment/internet connection (n = 13; 8.6%), scheduling difficulty (n = 2; 1.3%), difficulty following directions (n = 10; 6.6%), and patient-reported discomfort (n = 2; 1.3%). Barriers based on patient characteristics were age > 61 years, non-English primary language, inexperience with video conferencing, and unwillingness to try telemedicine prior to COVID-19. Conclusion The barriers identified in this study could be used to screen patients who would potentially have an unsuccessful telemedicine visit, allowing practices to provide assistance to patients to reduce the risk of an unsuccessful visit. Cite this article: Bone Jt Open 2021;2(9):745–751.

Environmental sustainability in orthopaedic surgery

“…62 This is becoming more commonplace in orthopaedic surgery, with its use further accelerated by the COVID-19 pandemic. [63][64][65] The carbon emissions reduced through minimizing travel are demonstrated by Curtis et al 49 and supported by Purohit et al 66 Telemedicine can be a valuable asset in supporting a more environmentally sustainable speciality; however, this cannot replace all orthopaedic appointments. Water usage.…”

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

“…The presented work does not include a broad discussion of the barriers and limitations of telemedicine in orthopedics. On the one hand, the current research was not aimed at analyzing them; on the other hand, in many studies, these issues have already been discussed quite extensively [37,61,62,114,115]. Weaknesses of the presented research result from the individual material may show some bias.…”

“…The telemedicine setting can be difficult for elderly orthopedic patients. However, telemedicine-oriented patient education may well solve the problem [37,61,62]. Studies conducted for virtual consultations for orthopedics usually focus on new solutions and technologies [59,[63][64][65][66][67][68][69], patient and clinician satisfaction [4,24,26,46,49,[70][71][72][73][74][75][76][77], clinical outcome measures [78][79][80][81][82], and cost analysis of traditional versus teleconsultation [82][83][84][85][86][87].…”

Telehealth for a better service delivery in orthopaedic surgery

“…1 The COVID-19 pandemic has resulted in an accelerated adoption and expansion of its applications, and it has become an integral part of healthcare delivery. 2 It bears the potential to augment clinical practice and change the way we approach patient care, prompting McKinsey to call it the quarter-trillion-dollar post-COVID-19 reality. 3…”

“…Cost is important, and one must consider the sizeable cost of the equipment installation, software acquisition, data security, high internet speed, personnel training, and maintenance. 2,8 In a study by Buvik et al, 9 the cost associated with telehealth equipment purchase was €16,511 and an additional €20,684 was spent annually for training and rent. Telehealth was found to be cost-effective when the number of virtual consultations exceeded 151 per year.…”