Telemedicine Use and Safety after Major Colorectal Surgery

ABSTRACT

Introduction: The COVID-19 pandemic has rapidly expanded the use of telemedicine in modern healthcare, especially in surgical care. Consensus over telemedicine use after major colorectal surgery remains unclear. The objectives of this study were 1) to evaluate telemedicine use after major colorectal surgery and 2) to assess safety, specifically 30-day mortality. Method(s) This is a retrospective multi-institutional cohort study across a healthcare system in the northeastern US. We included adult patients undergoing major colorectal surgery requiring inpatient admission at 4 hospitals from January 1, 2020 to June 30, 2020. Patients evaluated with in-person vs telemedicine follow-up were identified through electronic medical record documentation of appointment type. Multivariate logistic regression was used to identify variables predicting telemedicine use. Result(s) Among 295 patients, 164 (55.6%) had at least 1 telemedicine visit after surgery. Specifically, 131 patients (44.4%) had only in-person visits, 163 patients (55.3%) had a hybrid of in-person and telemedicine visits, and 1 patient (0.3%) had only telemedicine visits. The median age was 62.0 years (IQR 51.15-72.6), and 56.8% of patients were male. 89% patients were White, and 95.9% patients reported English as their first language. There were no differences in telemedicine use in the cohort based on age, gender, race, language, or hospital. The 30-day mortality was similar for patients seen with telemedicine and with in-person only visits (6.7 vs 2.3%, p = 0.074). Conclusion(s) Use of telemedicine is safe and supplements in-person visits during colorectal surgery recovery. Future research should evaluate impact of telemedicine use on patient satisfaction and opportunity cost.