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Patient and surgeon experiences with video visits in plastic surgery-toward a data-informed scheduling triage tool.
Brown-Johnson, Cati G; Spargo, Tavish; Kling, Samantha M R; Saliba-Gustafsson, Erika A; Lestoquoy, Anna Sophia; Garvert, Donn W; Vilendrer, Stacie; Winget, Marcy; Asch, Steven M; Maggio, Paul; Nazerali, Rahim S.
  • Brown-Johnson CG; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA. Electronic address: catibj@stanford.edu.
  • Spargo T; Division of Plastic and Reconstructive Surgery, Stanford Health Care, Stanford, CA.
  • Kling SMR; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA.
  • Saliba-Gustafsson EA; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA.
  • Lestoquoy AS; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA.
  • Garvert DW; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA.
  • Vilendrer S; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA.
  • Winget M; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA.
  • Asch SM; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA.
  • Maggio P; Department of Surgery, Stanford Health Care, Stanford, CA.
  • Nazerali RS; Division of Plastic and Reconstructive Surgery, Stanford Health Care, Stanford, CA.
Surgery ; 170(2): 587-595, 2021 08.
Article in English | MEDLINE | ID: covidwho-1213531
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 provided the impetus for unprecedented adoption of telemedicine. This study aimed to understand video visit adoption by plastic surgery providers; and patient and surgeon perceptions about its efficacy, value, accessibility, and long-term viability. A secondary aim was to develop the proposed 'Triage Tool for Video Visits in Plastic Surgery' to help determine visit video eligibility.

METHODS:

This mixed-methods evaluation assessed provider-level scheduling data from the Division of Plastic and Reconstructive Surgery at Stanford Health Care to quantify telemedicine adoption and semi-structured phone interviews with patients (n = 20) and surgeons (n = 10) to explore stakeholder perspectives on video visits.

RESULTS:

During the 13-week period after the local stay-at-home orders due to coronavirus disease 2019, 21.4% of preoperative visits and 45.5% of postoperative visits were performed via video. Video visits were considered acceptable by patients and surgeons in plastic surgery in terms of quality of care but were limited by the inability to perform a physical examination. Interviewed clinicians reported that long-term viability needs to be centered around technology (eg, connection, video quality, etc) and physical examinations. Our findings informed a proposed triage tool to determine the appropriateness of video visits for individual patients that incorporates visit type, anesthesia, case, surgeon's role, and patient characteristics.

CONCLUSION:

Video technology has the potential to facilitate and improve preoperative and postoperative patient care in plastic surgery but the following components are needed patient education on taking high-quality photos; standardized clinical guidelines for conducting video visits; and an algorithm-assisted triage tool to support scheduling.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Surgery, Plastic / Telemedicine / Surgeons / COVID-19 Type of study: Experimental Studies / Prognostic study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Surgery Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Surgery, Plastic / Telemedicine / Surgeons / COVID-19 Type of study: Experimental Studies / Prognostic study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Surgery Year: 2021 Document Type: Article