Telephone Follow-Up by a Midlevel Provider After Laparoscopic Inguinal Hernia Repair Instead of Face-to-Face Clinic Visit

Abstract

Background and Objectives:The need for more cost- and time-efficient provision of medical care has prompted an interest in remote or telehealth approaches to delivery of health care. We present a study examining the feasibility and outcomes of implementation of a telephone follow-up program for laparoscopic inguinal hernia repair.Methods:This is a retrospective review of consecutive patients who prospectively agreed to undergo telephone follow-up after laparoscopic inguinal hernia repair instead of standard face-to-face clinic visits. Patients received a telephone call from a dedicated physician assistant 2 to 3 weeks after surgery and answered a predetermined questionnaire. A face-to-face clinic visit was scheduled based on the results of the call or on patient request.Results:Of 62 patients who underwent surgery, all agreed to telephone follow-up instead of face-to-face clinic visits. Their mean round-trip distance to the hospital was 122 miles. Fifty-five patients (88.7%) successfully completed planned telephone follow-up. Three patients (4.8%) were lost to follow-up, and 4 (6.5%) were erroneously scheduled for a clinic appointment. Of the 55 patients who were reached by telephone, 50 (90.9%) were satisfied and declined an in-person clinic visit. Five patients (9.1%) returned for a clinic appointment based on concerns raised during the telephone call. Of these, 1 was found to have an early hernia recurrence and 1 had a seroma.Conclusion:Telephone follow-up by a midlevel provider after laparoscopic inguinal hernia repair is feasible and effective and is well received by patients.

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

“…Telemedicine was used during the postoperative period on 3 primary timetables: for scheduled follow-up, 45–54 for routine and ongoing monitoring, 43,44,51,55,58 or for management of issues as they arose. 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.…”

“…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.…”

Substitution of Usual Perioperative Care by eHealth to Enhance Postoperative Recovery in Patients Undergoing General Surgical or Gynecological Procedures: Study Protocol of a Randomized Controlled Trial

“…In addition patients will receive a telephone call 2 weeks after surgery to inform them about any test results. Various studies already have proven that telephone follow-up is feasible and effective after the type of surgical procedures which are included in this study [26-28]. The telehealth follow-up aims to replace the standard single postoperative consultation in the outpatient clinic to increase access to care, reduce patient uncertainties and fear related to the recovery process, reduce costs and workload, and meet patient preferences of care during out-of-office hours [29,30].…”

Postoperative care using a secure online patient portal: changing the (inter) face of general surgery

“…[33][34][35][36][37] Still others have eliminated both "hands-on" and visual assessments, using telephone to follow-up adults after laparoscopic cholecystectomy and inguinal hernia repair as well as a variety of minor pediatric general surgical procedures. [38][39][40] Both video and telephone-based care are limited in that they must be performed in a synchronous fashion, with both patient and surgeon available concurrently to participate in follow-up. Telephone assessments are further limited in their inability to visually assess the surgical site.…”