Early experience with focused telemedicine implementation in an academic colorectal surgery practice

ABSTRACT

Purpose/Background: With advances in technology there has been increased interest in and application of telemedicine in clinical practice. The need to continue providing care to patients during the COVID-19 pandemic facilitated telemedicine's rapid adoption. We evaluated the integration of telemedicine into an academic colorectal surgery practice. Methods/Interventions: All patients seen in a single center academic colorectal surgery practice from March 31, 2020 to August 31, 2020 were evaluated, and patients who were seen via telemedicine were evaluated for demographic information, diagnosis and disease history, and outcome of telemedicine visit. All physicians who provided care during this time period were asked to complete a survey regarding their experience providing telemedicine visits. Results/Outcome(s) A total of 231 telemedicine visits were performed by four providers, comprising 20% of all clinic visits during the study period. Patients were 47.6% male and 90.9% white. Most (85.7%) were established patient visits and 49 (21.2%) patients were seen for postoperative visits. Diagnoses evaluated by telemedicine included benign anorectal disease (9.1%), malignant anal disease (2.6%), inflammatory bowel disease (22.9%), benign colorectal disease (20.3%), and colorectal cancer (38.5 %). Of the 55 procedures planned during these visits, 41 (74.5%) were performed (Table). None of the four providers reported providing telemedicine visits prior to the COVID-19 pandemic, though all felt able to provide adequate care via telemedicine and were planning to continue providing telemedicine care in the future. They reported seeing the same or fewer total patients while providing telemedicine and reported comfort with evaluating a variety of pathologies, with all four reporting that they saw established colorectal cancer and inflammatory bowel disease patients as well as postoperative visits. Three out of four providers, however, reported that 50% or more of the patients that they saw via telemedicine would need an in-person evaluation. Conclusions/Discussion: During the COVID-19 pandemic telemedicine visits were rapidly and successfully integrated into this colorectal surgery practice. These were most successfully used to facilitate care for already established patients, particularly in the long-term care of colorectal cancer and inflammatory bowel disease patients, as well in the immediate postoperative period. This represents an exciting advancement in the clinical care of patients, though ongoing study remains to be done in how best to provide access this technology and full clinical care for colorectal surgery patients.