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Teleconsultation in the Management of Elective Orthopedic and Spinal Conditions During the COVID-19 Pandemic: Prospective Cohort Study of Patient Experiences.
Melian, Christina; Frampton, Christopher; Wyatt, Michael Charles; Kieser, David.
  • Melian C; Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States.
  • Frampton C; University of Otago, Christchurch, New Zealand.
  • Wyatt MC; University of Otago, Christchurch, New Zealand.
  • Kieser D; Christchurch School of Medicine, Christchurch, New Zealand.
JMIR Form Res ; 5(6): e28140, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1247762
ABSTRACT

BACKGROUND:

The global adoption of teleconsultation has been expedited as a result of the COVID-19 pandemic. By allowing remote communication, teleconsultation may help limit the spread of the virus while maintaining the crucial patient-provider relationship.

OBJECTIVE:

The aim of this study is to evaluate the value of teleconsultation compared to in-person visits in the management of elective orthopedic and spinal procedures.

METHODS:

This was a prospective observational cohort study of 853 patients receiving orthopedic and spinal care at a private outpatient clinic in New Zealand. Patients were randomly divided into two groups (1) patients receiving telephone consultation remotely, and (2) patients receiving in-person office consultations at the outpatient clinic. All patients received telephone consultations for 4 weeks during the mandated COVID-19 lockdown, followed by 4 weeks of telephone or in-person consultation. Patient preference, satisfaction, and duration of visit were recorded. Comparisons of patient preference between groups, visit type, sex, and location were performed using chi-square tests; similarly, satisfaction scores and visit durations were compared using a general linear model.

RESULTS:

We report that 91% (353/388) of patients in the telephone group preferred teleconsultation over in-person office visits during the COVID-19 lockdown (P<.001). A combined-group analysis showed that 55.3% (446/807) of all patients preferred teleconsultation compared to 31.2% (252/807) who preferred in-person office visits (P<.001). Patients in the telephone group reported significantly higher satisfaction scores (mean 9.95, SD 0.04, 95% CI 9.87-10.03) compared to patients in the in-person group (mean 9.53, SE 0.04, 95% CI 9.45-9.62; P<.001). Additionally, in-person consultations were significantly longer in duration compared to telephone consultations, with a mean visit time of 6.70 (SE 0.18) minutes, 95% CI 6.32-7.02, compared to 5.10 (SE 0.17) minutes, 95% CI 4.73-5.42 (P<.001).

CONCLUSIONS:

Patients who use telephone consultations are more likely to prefer it over traditional, in-person visits in the future. This increased preference, coupled with higher patient satisfaction scores and shorter duration of visits, suggests that teleconsultation has a role in orthopedic surgery, which may even extend beyond the COVID-19 pandemic.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Language: English Journal: JMIR Form Res Year: 2021 Document Type: Article Affiliation country: 28140

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Language: English Journal: JMIR Form Res Year: 2021 Document Type: Article Affiliation country: 28140