The Use of Online Video Consultations in the Aftercare of Orthopedic Patients: a Prospective Case-control Study

Abstract

Background: Video consultations have proven to be a powerful support for patient-doctor interactions, not only at times of the Covid-19 pandemic. This study analyzed both patients’ and doctors’ acceptance of an orthopedic telemedical consultation (OTC) and compared the examination results of OTC to live consultation (LC) results for discrepancies.Methods: The study was carried out in an orthopedic department of a German hospital between 2019 and 2020. After written informed consent, patients presented voluntarily for follow-ups by OTC and additionally in LC. Both patients and doctors were evaluated for their OTC experience and attitude (Likert-scaled and open questions, 26 to 28 items). The examination results of the OTC versus the LC were compared using a 12-items-checklist. Data was analyzed by quantitative and qualitative statistics. Results: A total of 53 patient cases were included. The OTC atmosphere was rated as pleasant and the experience as very satisfying (average rating on 5-point Likert-Scale, with 1 as strong agreement: doctors: 1.2; patients: 1.3). Various technical and organizational challenges could be identified. OTC, compared to LC, showed no significant differences in patient history, and for results in inspection, palpation and active range of motion. Only in the functional or “passive joint assessment” LC showed a significantly higher suitability (p < 0.05) compared to OTC. Recommendations for further procedures as a result from the OTC, did not significantly differ from the LC.Conclusion: Because of the positive acceptance and the objective benefit of OTC, with very similar clinical results to LC, OTC is recommendable for orthopedic follow-up examinations. In order to assess the functionality of a joint even better, meaningful digital alternatives for already established examination methods should be further investigated.