Otolaryngology Treatment and Surgical Planning via Telemedicine

ABSTRACT

Introduction: The objective of this study is to determine the likelihood of diagnosis and accuracy of treatment of various conditions via use of telemedicine services within an academic, multisubspecialty otolaryngology practice located in a COVID-19 hot spot. At the conclusion of this presentation, the participants should be able to understand the role that virtual care can play in otolaryngology, both in terms of diagnosis and management. Method(s) This retrospective cohort study included all telemedicine patient encounters with an otolaryngologist or advanced practice provider between March 17 and August 30, 2020. Pediatric and adult patients who completed a synchronous virtual visit (VV) were included. Patient demographics, new vs return patients, known and unknown visit diagnoses, treatment given and/or surgery scheduled, and recommended in-person follow-up were extracted. If in-person follow-up occurred, the diagnosis, whether scope was performed, and if in-person follow-up changed the diagnosis were extracted. A t test and chi2 analysis were utilized. Result(s) A total of 758 patients completed a VV;388 were new and 370 return patients. New patients were significantly younger than return patients (44.3 vs 48.2 years, P=.014). New patients with a known diagnosis were treated more often than return patients (80.6% vs 67.2%, P=.008). There was no significant difference between new and return patients in treatment given, recommendation for in-person follow-up, rate of in-person follow-up, rate of patients scoped, and if recommendations were made for surgery. Treatment was recommended in 71.1% of encounters, and surgery was recommended in 10.8% of encounters. The endocrine subgroup had the highest rate at 60.6% (CI, 42.1, 77.1) of recommending surgery. Conclusion(s) Telemedicine is an effective tool when used for diagnosis, as well as to recommend treatment and surgery when in-person visits are difficult or not possible.