The Aesthetic Oculoplastic Surgery Video Teleconference Consult

Abstract

Background Skype video telemedicine consults are gaining popularity to evaluate patients from distant locations. No study has analyzed the utility of this means of patient evaluation in a cosmetic oculoplastic patient population. Objectives The authors sought to provide an evidence-based analysis of the utility of Skype video consults in a cosmetic oculoplastic surgery patient population with regards to patient demographics, reasons for consult, and procedural conversion rate. Methods A 1-year retrospective chart review (May 2016 to May 2017) of patients who underwent aesthetic oculoplastic Skype consults from 2 authors’ practices was performed. The authors analyzed patient demographics, referral source, chief complaint, location of residence, length of consult, and conversion to face-to-face consultation and intervention. Results Seventy-nine patients (60 women and 19 men) underwent Skype evaluations. Mean age was 49 years. Sixty-four consults (81%) lasted 15 minutes or less. Referral sources included the internet (67%), another physician (19%), self-referral (7.5%), referred by former patients (4%), and social media sites (2.5%). Consultations were obtained for revision (49%), or first-time (30%) eyelid/eyebrow surgery, cosmetic ptosis surgery (6%), laser skin procedures (5%), cosmetic orbital decompression (5%), and lower eyelid fat prolapse (5%). Twenty patients (25%) followed-up with in-person consultation. Sixteen of these patients (80%) had surgical (56%) or nonsurgical (44%) interventions. Conclusions Skype consults are an efficient, in-office modality to increase patient flow through the office, expand patient base, and generate income. In this report, 25% of Skype contacts followed-up with formal in-person consultations, of which 80% had surgical or nonsurgical interventions.

Ophthalmology Practice During the Coronavirus Disease 2019 Pandemic: The University of Pittsburgh Experience in Promoting Clinic Safety and Embracing Video Visits

“…Anterior Segment and Ocular Adnexa Video visits allow for at least gross examination of the ocular adnexa and anterior segment. Video visit encounters have been reported for initial patient consultation for cosmetic facial or eyelid surgery [28], and remote assessment of ptosis by photographs has good agreement with subsequent office evaluation [29].…”

Trends and Challenges of Telehealth in an Academic Institution: The Unforeseen Benefits of the COVID-19 Global Pandemic

“…These statistics complement those reported by Hwang et al, who also found a 25% conversion rate to formal in-person consultations among new patients initially seen via Skype in their cosmetic oculoplastic practices. 4 …”

“…Informed consent obligations are generally the same as those required for in-person treatment, and clinicians should adhere to the same standards of traditional office encounters. 4 Following standard-of-care practices required by federal and state laws should avoid any missteps. It is important to note that informed consent laws vary between states; some require written consent and others allow verbal consent.…”

“…This restructuring has shed light on some unrealized advantages telehealth may offer, such as increasing new patient flow, expanding a practice’s patient base, generating additional income for the practice, expanding access, improving workflows, increasing patient satisfaction and cutting down patient cost. 4 With governmental agencies temporarily loosening restrictive regulations, now is the time to devise effective telehealth systems. This will not only be essential to sustain patient care during this crisis but can also be utilized during normal times after the pandemic has passed.…”

Oculoplastic video-based telemedicine consultations: Covid-19 and beyond

“…Akin to dermatology, oculoplastic conditions are suited for telemedicine as most relevant clinical signs can be elicited without the aid of specialist equipment such as a slit lamp. Most devices used for video consultations would provide sufficient resolution for the objective assessment of oculoplastic parameters [3][4][5][6] and those examinations that cannot be conducted effectively (for example, visual acuity or optic nerve function testing) have often been conducted already by the referrer or during a previous examination.…”