Background: During the COVID-19 pandemic, measures were taken to decrease viral spread by transitioning health care appointments to virtual mediums. This study evaluates the use of telemedicine within the Divisions of Colon and Rectal Surgery and Otolaryngology-Neurotology at a single academic institution during the COVID-19 pandemic.
Study Design: An online survey modeled after the TeleENT Satisfaction Questionnaire and the Medical Communication Competence Scale (MCCS) was administered to gauge patient’s experience with Electronic Medical Record-based telemedicine visits.
Results: Participants noticed several advantages of telemedicine visits over traditional in-office visits: shorter visits, saving money, and avoiding potential exposure during the pandemic. A total of 36% at least somewhat agreed that the quality of care was hindered by the lack of a physical examination;61.7% participants at least somewhat agreed that they prefer a face-to-face visit rather than telemedicine consultation. Most patients were satisfied with the care they received via telemedicine (Likert 6.19/7) and 95.8% would use telemedicine again. Participants self-reported an average saving of $108.70 when using telemedicine. When comparing the telemedicine cohort with the in-office control, the telemedicine patients noticed an improved ability to communicate with their physician in five out of eight domains of the MCCS.
Conclusion: Surgical preoperative consultation, postoperative follow-up, and routine visits were conducted via telemedicine during the COVID-19 pandemic, representing a new direction for surgical appointments and consultations. This study shows that telehealth can provide satisfactory care and increases access to surgical care for patients when external factors prevent the traditional physician–patient interaction. With better-perceived communication via telemedicine appointments, patients may subjectively feel that they can express their symptoms and gather information from the doctor regarding their diagnosis more efficiently.
Surgeons AC. COVID-19: Recommendations for management of elective surgical procedures. 2020;
2.
Mascagni D, Eberspacher C, Mascagni P, Arezzo A, Selvaggi F, Sturiale A, et al. From high volume to “zero” proctology: Italian experience in the COVID era. International Journal of Colorectal Disease. 2020;35(9):1777–80.
3.
Pignatti M, Pinto V, Miralles MEL, Giorgini FA, Cannamela G, Cipriani R. How the COVID-19 pandemic changed the Plastic Surgery activity in a regional referral center in Northern Italy. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2020;73(7):1348–56.
4.
Plocienniczak MJ, Noordzij JP, Grillone G, Platt M, Brook C. Guidelines for Resident Participation in Otolaryngology Telehealth Clinics During the COVID‐19 Pandemic. Otolaryngology–Head and Neck Surgery. 2020;163(3):498–500.
5.
Shipchandler TZ, Nesemeier BR, Parker NP, Vernon D, Campiti VJ, Anthony BP, et al. Telehealth Opportunities for the Otolaryngologist: A Silver Lining During the COVID‐19 Pandemic. Otolaryngology–Head and Neck Surgery. 2020;163(1):112–3.
6.
Shirke MM, Shaikh SA, Harky A. Tele-oncology in the COVID-19 Era: The Way Forward? Trends in Cancer. 2020;6(7):547–9.
7.
Tanaka MJ, Oh LS, Martin SD, Berkson EM. Telemedicine in the Era of COVID-19. Journal of Bone and Joint Surgery. 2020;102(12):e57.
8.
Vecchione L, Stintzing S, Pentheroudakis G, Douillard JY, Lordick F. ESMO management and treatment adapted recommendations in the COVID-19 era: colorectal cancer. ESMO Open. 2020;5:e000826.
9.
Walędziak M, Różańska-Walędziak A, Pędziwiatr M, Szeliga J, Proczko-Stepaniak M, Wysocki M, et al. Bariatric Surgery during COVID-19 Pandemic from Patients’ Point of View—The Results of a National Survey. Journal of Clinical Medicine. 9(6):1697.
10.
Seim NB, Philips RHW, Matrka LA, Locklear B, Inman M, Moberly AC, et al. Developing a synchronous otolaryngology telemedicine Clinic: Prospective study to assess fidelity and diagnostic concordance. The Laryngoscope. 2018;128(5):1068–74.
11.
Cegala DJ, Coleman MT, Turner JW. The Development and Partial Assessment of the Medical Communication Competence Scale. Health Communication. 1998;10(3):261–88.
12.
Layfield E, Triantafillou V, Prasad A, Deng J, Shanti RM, Newman JG, et al. Telemedicine for head and neck ambulatory visits during <scp>COVID</scp>‐19: Evaluating usability and patient satisfaction. Head & Neck. 2020;42(7):1681–9.
13.
Ungar OJ, Handzel O, Cavel O, Oron Y. A Smartphone-Based Weber Test May Discriminate between a Conductive and a Sensorineural Hearing Loss. Audiology and Neurotology. 2019;24(4):191–6.
14.
Buvik A, Bugge E, Knutsen G, Småbrekke A, Wilsgaard T. Patient reported outcomes with remote orthopaedic consultations by telemedicine: A randomised controlled trial. Journal of Telemedicine and Telecare. 2019;25(8):451–9.
15.
Goedeke J, Ertl A, Zöller D, Rohleder S, Muensterer OJ. Telemedicine for pediatric surgical outpatient follow-up: A prospective, randomized single-center trial. Journal of Pediatric Surgery. 2019;54(1):200–7.
16.
Hwa K, Wren SM. Telehealth Follow-up in Lieu of Postoperative Clinic Visit for Ambulatory Surgery. JAMA Surgery. 2013;148(9):823.
17.
Broman KK, Roumie CL, Stewart MK, Castellanos JA, Tarpley JL, Dittus RS, et al. Implementation of a Telephone Postoperative Clinic in an Integrated Health System. Journal of the American College of Surgeons. 2016;223(4):644–51.
18.
Nikolian VC, Williams AM, Jacobs BN, Kemp MT, Wilson JK, Mulholland MW, et al. Pilot Study to Evaluate the Safety, Feasibility, and Financial Implications of a Postoperative Telemedicine Program. Annals of Surgery. 2018;268(4):700–7.
19.
Soegaard Ballester JM, Scott MF, Owei L, Neylan C, Hanson CW, Morris JB. Patient preference for time-saving telehealth postoperative visits after routine surgery in an urban setting. Surgery. 2018;163(4):672–9.
20.
Williams AM, Bhatti UF, Alam HB, Nikolian VC. The role of telemedicine in postoperative care. mHealth. 4:11–11.
21.
Shapiro SB, Lipschitz N, Kemper N, Zuccarello M, Breen JT, Pensak ML, et al. Early Experience With Telemedicine in Patients Undergoing Otologic/Neurotologic Procedures. Otology & Neurotology. 2020;41(9):e1154–7.
22.
Mullen-Fortino M, Rising KL, Duckworth J, Gwynn V, Sites FD, Hollander JE. Presurgical Assessment Using Telemedicine Technology: Impact on Efficiency, Effectiveness, and Patient Experience of Care. Telemedicine and e-Health. 2019;25(2):137–42.
23.
Mobile fact sheet. Pew Research Center. 2019;
24.
Viers BR, Lightner DJ, Rivera ME, Tollefson MK, Boorjian SA, Karnes RJ, et al. Efficiency, Satisfaction, and Costs for Remote Video Visits Following Radical Prostatectomy: A Randomized Controlled Trial. European Urology. 2015;68(4):729–35.
25.
Holt B, Faraklas I, Theurer L, Cochran A, Saffle JR. Telemedicine Use Among Burn Centers in the United States. Journal of Burn Care & Research. 2012;33(1):157–62.
26.
Gunter RL, Chouinard S, Fernandes-Taylor S, Wiseman JT, Clarkson S, Bennett K, et al. Current Use of Telemedicine for Post-Discharge Surgical Care: A Systematic Review. Journal of the American College of Surgeons. 2016;222(5):915–27.
27.
Safir IJ, Gabale S, David SA, Huang JH, Gerhard RS, Pearl J, et al. Implementation of a Tele-urology Program for Outpatient Hematuria Referrals: Initial Results and Patient Satisfaction. Urology. 2016;97:33–9.
28.
Cain SM, Moore R, Sturm L, Mason T, Fuhrman C, Smith R, et al. Clinical assessment and management of general surgery patients via synchronous telehealth. Journal of Telemedicine and Telecare. 2017;23(2):371–5.
29.
Jue JS, Spector SA, Spector SA. Telemedicine broadening access to care for complex cases. Journal of Surgical Research. 2017;220:164–70.
30.
Valsangkar NP, Eppstein AC, Lawson RA, Taylor AN. Effect of Lean Processes on Surgical Wait Times and Efficiency in a Tertiary Care Veterans Affairs Medical Center. JAMA Surgery. 2017;152(1):42.
31.
Guidolin K, Yan H, Quereshy F. The “teaching time-out”: a novel framework for surgical education. Canadian Journal of Surgery. 2020;63(3):E208–10.
32.
Asiri A, AlBishi S, AlMadani W, ElMetwally A, Househ M. The Use of Telemedicine in Surgical Care: a Systematic Review. Acta Informatica Medica. 2018;26(2):201.
33.
Model Policy for The Appropriate Use of Telemedicine Technologies in the Practice of Medicine. FSMB. 2014;
34.
Paquette S, Lin JC. Outpatient Telemedicine Program in Vascular Surgery Reduces Patient Travel Time, Cost, and Environmental Pollutant Emissions. Annals of Vascular Surgery. 2019;59:167–72.
35.
Schroeder C. Pilot study of telemedicine for the initial evaluation of general surgery patients in the clinic and hospitalized settings. Surgery Open Science. 2019;1(2):97–9.
36.
Catanese S, Pentheroudakis G, Douillard JY, Lordick F. ESMO Management and treatment adapted recommendations in the COVID-19 era: Pancreatic Cancer. ESMO Open. 2020;5:e000804.
37.
Contreras CM, Metzger GA, Beane JD, Dedhia PH, Ejaz A, Pawlik TM. Telemedicine: Patient-Provider Clinical Engagement During the COVID-19 Pandemic and Beyond. Journal of Gastrointestinal Surgery. 2020;24(7):1692–7.
38.
Grenda TR, Whang S, Evans NR. Transitioning a Surgery Practice to Telehealth During COVID-19. Annals of Surgery. 2020;272(2):e168–9.
39.
Hakim AA, Kellish AS, Atabek U, Spitz FR, Hong YK. Implications for the use of telehealth in surgical patients during the COVID-19 pandemic. The American Journal of Surgery. 2020;220(1):48–9.
40.
Hemingway JF, Singh N, Starnes BW. Emerging practice patterns in vascular surgery during the COVID-19 pandemic. Journal of Vascular Surgery. 2020;72(2):396–402.
41.
Kling SM, Philp MM. The effects of the COVID-19 pandemic on oncological surgery. Journal of Surgical Case Reports. 2020;2020(5).
42.
Latifi R, Doarn CR. Perspective on COVID-19: Finally, Telemedicine at Center Stage. Telemedicine and e-Health. 2020;26(9):1106–9.
Citation
Copyright
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
