The COVID-19 pandemic and follow-up for shoulder surgery: The impact of a shift toward telemedicine on validated patient-reported outcomes

Abstract

Introduction The emergence of COVID-19 and its ensuing restrictions on in-person healthcare has resulted in a sudden shift towards the utilization of telemedicine. The purpose of this study is to assess patient satisfaction and patient-reported outcome measures (PROMs) for individuals who underwent follow-up for shoulder surgery using telemedicine compared to those who received traditional in-person clinic follow-up. Methods Patients who underwent either rotator cuff repair or total shoulder arthroplasty during a designated pre-COVID-19 (traditional clinic follow-up) or peri-COVID-19 (telemedicine follow-up) span of time were identified. PROMs including the American Shoulder and Elbow Surgeons standardized assessment form, the three-level version of the EQ-5D form, the 12-Item Short Form survey, and a modified version of a published telemedicine survey were administered to participants six months post-operatively via phone call. Results Sixty patients agreed to participate. There was no significant difference between the pre-COVID-19 and peri-COVID-19 groups in patient satisfaction with their follow-up visit ( p = 0.289), nor was there a significant difference in PROMs between the two groups. In total, 83.33% of the telemedicine group and 70.37% of the in-person clinic group preferred traditional in-person follow-up over telemedicine. Discussion In a cohort of patients who underwent telemedicine follow-up for shoulder surgery during the COVID-19 pandemic, there was no difference in patient satisfaction and PROMs compared to traditional in-person clinic follow-up. This study indicates that while the majority of participants preferred face-to-face visits, patients were relatively satisfied with their care and had similar functional outcome scores in both groups, despite the large disruption in healthcare logistics caused by COVID-19.

Do Hospitals Need to Extend Telehealth Services? An Experimental Study of Different Telehealth Modalities during the COVID-19 Pandemic

“…The findings of previous studies regarding trust factors are variable as several clinical studies demonstrate the same or better outcomes, 34 and some studies show more inferior outcomes associated with consultations not done in person. 35 Our result implies that during the COVID-19 pandemic, people still believe they can trust in-person consultations with clinicians compared with four telehealth modalities to obtain better care planning and treatment options. A plausible justification is that an in-person examination may be considered more trustworthy because people think they can receive thorough and complete advice by visiting a clinician in person rather than chatting with them from a distance.…”

Telehealth for consultation and shoulder rehabilitation: a preliminary study on the perspectives of 30 patients during the COVID-19 lockdown

“…Ben-Ari et al [25] reported that the patients were highly satisfied with their telehealth encounters but had a significantly lower preference for future telehealth visits if there were no pandemic. Sabbagh et al [26] reported that there was no difference in satisfaction between the telemedicine group and the in-person consultation group of patients who were evaluated as follow-ups after an earlier shoulder cuff repair or a shoulder arthroplasty. A study by Steele et al [27] prior to the COVID pandemic also reported that patients were very satisfied with the telerehabilitation procedure.…”

The Telemedicine-Based Pediatric Examination of the Neck and Upper Limbs: A Narrative Review

“…After undergoing a virtual physical examination at followup, patient-reported outcome measures and pain scores were not significantly different from patients assessed through an in-person appointment. 53,58 Furthermore, 96% of surgical plans established in virtual visits did not change after inperson evaluation. 59 Although not validated in children, this evidence suggests that the telemedicine platform can be a reasonable follow-up model to consider for patients seeking convenient and effective care following their surgery.…”

“…These include the Constant score, 51 Shoulder Telehealth Assessment Tool (STAT) 52 and the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. 53 We remind physicians that using patient-reported scores developed for adults in their pediatric patients could result in unreliable data that has limited validity or applicability.…”