C. Jenny1, K. Gardner1, C. Ziegler1, E. Sutton1 1University Of Louisville,School Of Medicine,Louisville, KY, USA
Introduction:
Telemedicine is increasingly being used to improve accessibility and efficiency of health care delivery. We performed a pilot study employing telemedicine for emergency general surgery patients who underwent laparoscopic appendectomy or cholecystectomy for uncomplicated acute appendicitis or cholecystitis to assess feasibility and patient acceptance of telemedicine for routine postoperative evaluation.
Methods:
Patients were eligible for the study if they were between 18-90 years old and had undergone an uncomplicated laparoscopic appendectomy or cholecystectomy. The experimental group was set at 20 participants and the control group set at 10 participants. If participants did not have access to visual communication technology, a webcam was offered to the patient at no charge. After informed consent, the 20 patients in the experimental group were given a link to a web based meeting platform (http://bluejeans.com) and instructions about how to use a smartphone or computer with a webcam to log in at their specified meeting time with a meeting ID and password. Follow-up visits were subsequently evaluated with a six question online survey to determine patient satisfaction with video and audio quality, timing, and the patient’s receptiveness to future telemedicine visits (Likert scale 1-5, 1- strongly disagree, 5- strongly agree). Questionnaire results from this group were then compared to a control group of patients who experienced a traditional in office follow-up visit.
Results:
Sixty-three patients were approached about participation, 20 of which entered the study as telemedicine participants (31.7%). The 43 patients who did not participate in the study were invited to serve as controls. Of the telemedicine participants, 90% were satisfied with their telemedicine visit, and 85% of those patients would choose to use telemedicine again. Of the telemedicine participants, 75% would suggest the use of telemedicine to another physician. Satisfaction with the post operative visit was not significantly different between the telemedicine group and office visit group (4.2 vs 4.5, p=0.124). Only one telemedicine study participant took time off from work and 19 participants reported that their telemedicine visit took less than 1 hour of their time in total. In comparison, 90% of controls took greater than 1 hour including travel time to complete their in-office follow-up visit, with 2 participants (20%) taking greater than 4 hours. Eighteen out of our 20 study participants (90%) were comfortable with the technology they were required to use to operate the web based meeting platform.
Conclusion:
This study suggests that it is feasible to use telemedicine in the follow up of patients who have had uncomplicated laparoscopic appendectomies and cholecystectomies and that patient satisfaction is reasonably high. Future studies should be conducted examining the use of telemedicine for more complex perioperative care of the surgical patient.