Surgical patients who participate in virtual follow-up visits after their operations spend a similar amount of time with surgical team members as do those who meet face-to-face.
Additionally, these patients benefit from spending less time waiting and going to the clinic for in-person appointments, according to research findings presented at the American College of Surgeons Virtual Clinical Congress 2020.
I think it’s really valuable for patients to understand that, in the virtual space scenario, they will still have quality time with their surgical team. A virtual appointment does not reduce the time and there is still the possibility to answer questions, connect and contact ongoing medical assistance “.
Caroline Reinke, MD, FACS, lead author of the study, associate professor of surgery, Atrium Health in Charlotte, NC
Due to the Coronavirus Disease 2019 (COVID-19) pandemic and widespread adoption of the technology, many surgical patients are being offered virtual appointments instead of traditional in-person visits. The researchers say this is one of the first studies to examine how patients spend their time on post-operative virtual visits versus face-to-face consultations.
The study design was a randomized controlled non-inferiority study involving more than 400 patients who underwent laparoscopic appendectomy or cholecystectomy at two hospitals in Charlotte, NC and were randomized 2: 1 to a virtual post-discharge visit or to one in person visit. The study began in August 2017 but was suspended in March 2020 due to COVID-19.
“Other studies looked at the total visit time, but were unable to break down the specific amount of time the patient spends with the provider. And we wanted to know if it was the same or different between a virtual visit and an in-person visit. “said Dr. Reinke. “We wanted to get to the hard core of how much time was actually spent between the surgical team member and the patient.”
The researchers tracked the total time patients spent checking in, waiting in the waiting room and examination room, meeting with the surgical team member, and being discharged after the exam. For in-person visits, on-site waiting time and estimated driving time were taken into account in the overall time commitment.
Only 64% of patients completed the follow-up visit. “Sometimes, patients are doing so well after minimally invasive surgery that about 30 percent of these patients don’t show up for a post-operative visit,” said Dr. Reinke.
Overall, the results showed that total clinic time was longer for in-person visits than for virtual visits (58 minutes versus 19 minutes). However, patients in both groups spent the same amount of time in front of a member of their surgical team (8.3 minutes versus 8.2 minutes) discussing their postoperative recovery.
“I was pleasantly surprised that the amount of time patients spent with the surgical team member was the same, because one of the main concerns with virtual visits is that patients feel disconnected and that there is no such thing. so much value in this, “said Dr. Reinke said.
Importantly, patients placed a high value on comfort and flexibility. “We have received extremely positive responses to this patient-centered care option.” Dr. Reinke said. “Patients were able to have the post-operative visit at work or at home while caring for the children, without having to interrupt their day in such a significant way.”
The researchers also found that patients embraced the virtual scenario. The satisfaction rate between the two patient groups was similar (94% versus 98%).
Furthermore, the waiting time was much shorter for patients receiving virtual care. “Even for virtual visits, the amount of time patients spent checking and waiting was about 55% of the total time. Because virtual visits have the same rules as in-person visits, even if you eliminate room members waiting and patient flow within the clinic, patients are still dedicating about half of their time to check-in logistics, ”said Dr. Reinke. “However, with virtual visits, there is still a lot less time spent waiting, around 80% less.”
However, some patients are not comfortable with the technology. The number of patients who could not or did not want to take a virtual visit was higher than expected, according to the authors.
“I think there are some patients who would actually prefer to come in and shake someone’s hand,” said Dr. Reinke. “I think for surgery it’s a bit different, because with surgical care there are incisions to check. However, we were able to check the incisions quite easily, having patients show us their incisions virtually on the video screen.” .
American College of Surgeons