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Barajas JN, Hornung AL, Kuzel T, Mallow GM, Park GJ, Rudisill SS, Louie PK, Harada GK, McCarthy MH, Germscheid N, Cheung JP, Neva MH, El-Sharkawi M, Valacco M, Sciubba DM, Chutkan NB, An HS, Samartzis D. The Impact of COVID-19 Pandemic on Spine Surgeons Worldwide: A One Year Prospective Comparative Study. Global Spine J 2024; 14:956-969. [PMID: 36176014 PMCID: PMC9527127 DOI: 10.1177/21925682221131540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
STUDY DESIGN Survey. OBJECTIVE In March of 2020, an original study by Louie et al investigated the impact of COVID-19 on 902 spine surgeons internationally. Since then, due to varying government responses and public health initiatives to the pandemic, individual countries and regions of the world have been affected differently. Therefore, this follow-up study aimed to assess how the COVID-19 impact on spine surgeons has changed 1 year later. METHODS A repeat, multi-dimensional, 90-item survey written in English was distributed to spine surgeons worldwide via email to the AO Spine membership who agreed to receive surveys. Questions were categorized into the following domains: demographics, COVID-19 observations, preparedness, personal impact, patient care, and future perceptions. RESULTS Basic respondent demographics, such as gender, age, home demographics, medical comorbidities, practice type, and years since training completion, were similar to those of the original 2020 survey. Significant differences between groups included reasons for COVID testing, opinions of media coverage, hospital unemployment, likelihood to be performing elective surgery, percentage of cases cancelled, percentage of personal income, sick leave, personal time allocation, stress coping mechanisms, and the belief that future guidelines were needed (P<.05). CONCLUSION Compared to baseline results collected at the beginning of the COVID-19 pandemic in 2020, significant differences in various domains related to COVID-19 perceptions, hospital preparedness, practice impact, personal impact, and future perceptions have developed. Follow-up assessment of spine surgeons has further indicated that telemedicine and virtual education are mainstays. Such findings may help to inform and manage expectations and responses to any future outbreaks.
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Affiliation(s)
- Juan N Barajas
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
| | - Alexander L Hornung
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
| | - Timothy Kuzel
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
| | - Gary M Mallow
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
| | - Grant J Park
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
| | - Samuel S Rudisill
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
| | - Philip K Louie
- Department of Neurosurgery, Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA
| | - Garrett K Harada
- Department of Radiation Oncology, University of California Irvine, Orange, CA, USA
| | | | | | - Jason Py Cheung
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, SAR China
| | - Marko H Neva
- Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, Finland
| | - Mohammad El-Sharkawi
- Department of Orthopaedic and Trauma Surgery, Assiut University Medical School, Assiut, Egypt
| | - Marcelo Valacco
- Department of Orthopaedics, Churruca Hospital de Buenos Aires, Buenos Aires, Argentina
| | - Daniel M Sciubba
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead, NY, USA
| | - Norman B Chutkan
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Howard S An
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
| | - Dino Samartzis
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- International Spine Research & Innovation Initiative (ISRII), Chicago, IL, USA
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Yılmaz HG, Büyükaslan A, Kuşvuran A, Turan Z, Tuna F, Tunc H, Özdoğan S. A New Clinical Tool for Scoliosis Risk Analysis: Scoliosis Tele-Screening Test. Asian Spine J 2023; 17:656-665. [PMID: 37226382 PMCID: PMC10460665 DOI: 10.31616/asj.2022.0299] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 05/26/2023] Open
Abstract
STUDY DESIGN Methodological, observational clinical study. PURPOSE This study aimed to develop a virtual screening test to detect scoliosis risk initially by parents without the need for medical visit during the coronavirus disease 2019 pandemic. OVERVIEW OF LITERATURE The scoliosis screening program has been implemented to early detect scoliosis. Unfortunately, access to health professionals was limited during the pandemic. However, during this time, interest in telemedicine has increased remarkably. Recently, mobile applications related to postural analysis were developed, but none permits evaluation by parents. METHODS Researchers developed the Scoliosis Tele-Screening Test (STS-Test), which included drawing-based images of body asymmetries, to assess the scoliosis-associated risk factors. The STS-Test was shared on social networks, allowing the parents to evaluate their children. After test completion, the risk score was generated automatically, and children with medium and high risks were then advised for medical consultation for further evaluation. The test accuracy and consistency between the clinician and parents were also analyzed. RESULTS Of the 865 tested children, 358 (41.4%) consulted clinicians to confirm their STS-Test results. Scoliosis was then confirmed in 91 children (25.4%). The parents were able to detect asymmetry in 50% of the lumbar/thoracolumbar curvatures and 82% of the thoracic curvatures. In addition, the forward bend test revealed favorable agreement between parents and clinicians (r =0.809, p<0.0005). Internal consistency of the esthetic deformities domain in the STS-Test was also excellent (α=0.901). This tool was 94.97% accurate, 83.51% sensitive, and 98.87% specific. CONCLUSIONS The STS-Test is a new parent-friendly, virtual, cost-effective, result-oriented, and reliable tool for scoliosis screening. It allows parents to actively participate in the early detection of scoliosis by screening their children for the risk of scoliosis periodically without the need to visit the health institution.
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Affiliation(s)
| | - Ahsen Büyükaslan
- Formed Healthcare Scoliosis Treatment and Brace Center, Istanbul, Turkey
- Institute of Kinesiology, University of Ljubljana, Ljubljana, Slovenia
- Department of Physical Therapy and Rehabilitation, Graduate School of Health Sciences, Medipol University, Istanbul, Turkey
| | - Aslihan Kuşvuran
- Department of Physical Medicine and Rehabilitation, Faculty of Health Sciences, Toros University, Mersin, Turkey
| | - Zeynep Turan
- Department of Physical Medicine and Rehabilitation, Koç University Hospital, Istanbul, Turkey
| | - Filiz Tuna
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Hande Tunc
- Formed Healthcare Scoliosis Treatment and Brace Center, Istanbul, Turkey
- Department of Physical Therapy and Rehabilitation, Graduate School of Health Sciences, Medipol University, Istanbul, Turkey
| | - Sibel Özdoğan
- Department of Physical Medicine and Rehabilitation, Medstar Antalya Hospital, Antalya, Turkey
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Mark J, Cooke DT, Suri A, Huynh TT, Yoon PS, Humphries MD. Patient and provider perspectives to utilization of telemedicine in surgery. Digit Health 2023; 9:20552076231152756. [PMID: 36818156 PMCID: PMC9936391 DOI: 10.1177/20552076231152756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/03/2023] [Indexed: 02/17/2023] Open
Abstract
Objectives Determine patient and provider perspectives on widespread rapid telemedicine implementation, understand the key components of a surgical telemedicine visit and identify factors that affect future telemedicine use. Summary of background data Compared to other specialties, the field of surgery heretofore has had limited adoption of telemedicine. During the COVID-19 pandemic Healthcare, including the surgical specialties, saw new widespread use of telemedicine. Methods We conducted a prospective cohort study during the COVID-19 California stay-at-home and physical distancing executive orders. Utilization data were collected from clinics and compared to usage data during the same time 1 year later. All patients and providers who participated in a telemedicine visit during the study period were asked to complete a survey after each encounter and the surveys were analyzed for trends in opinions on future use by stakeholders. Results Over the 10-week period, the median percentage of telemedicine visits per clinic was 33% (17%-51%) which peaked 3 weeks into implementation. One hundred and ninety-one patients (48% women) with a median age of 64 years (IQR 53-73) completed the patient survey. Patients were first-time participants in telemedicine in 41% (n = 79) of visits. Fifty-seven percent (n = 45) of first-time users preferred that future visits be in-person versus 31% of prior users (p = 0.007). The median travel time from home to the clinic was 40 min (IQR = 20-90). Patients with longer travel times were not more likely to use telemedicine in the future (61% with longer travel vs. 53% shorter, p = 0.11). From the 148 provider responses, 90% of the visits providers were able to create a definitive plan with the telemedicine visit. A physical exam was determined not to be needed in 45% of the visits. An attempt at any physical exam was not performed in 84% of routine follow-up or new-patient visits, compared to 53% of post-op visits (p = 0.001). Conclusion Telemedicine is a viable ambulatory visit option for surgical specialists and their patients. During rapid telemedicine deployment, travel distance did not correlate with increased use of telemedicine, and in-person visits are still preferred. However, nearly half of all visits did not need a physical exam, which favors telemedicine use.
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Affiliation(s)
- John Mark
- Department of Surgery, University of California, Davis Health, Sacramento, CA, USA
| | - David T Cooke
- Division of General Thoracic Surgery, University of California, Davis Health, Sacramento, CA, USA
| | - Avni Suri
- Department of Surgery, University of California, Davis Health, Sacramento, CA, USA
| | - Timothy T Huynh
- Division of General Thoracic Surgery, University of California, Davis Health, Sacramento, CA, USA
| | - Paul S Yoon
- Department of Surgery, University of California, Davis Health, Sacramento, CA, USA
| | - Misty D Humphries
- Department of Surgery, University of California, Davis Health, Sacramento, CA, USA,Misty D Humphries, University of California Davis, 2335 Stockton Blvd, NAOB 5001, Sacramento, CA 95811, USA.
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Nie JZ, Karras CL, Texakalidis P, Trybula SJ, Dahdaleh NS. A Systematic Review of Outpatient Telemedicine Use in Neurosurgery Since the Start of Coronavirus Disease 2019. World Neurosurg 2022; 167:e1090-e1102. [PMID: 36115568 DOI: 10.1016/j.wneu.2022.08.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has sparked interest in telemedicine, resulting in an increase in neurosurgical publications focused on it. We summarize this new literature to evaluate telemedicine applications to neurosurgery. METHODS A systematic literature review was performed in accordance with the PRISMA guidelines by searching PubMed, Embase, and Scopus for journal articles published after January 1, 2020. All journal articles that included data after the start of COVID-19 and evaluated any aspect of telemedicine relevant to outpatient neurosurgical visits were included. The premise and key findings of each included study were extracted, as well as patient and provider satisfaction with and preference for telemedicine. RESULTS Thirty-seven articles met the inclusion criteria. Four studies proposed and evaluated a remote neurologic examination. Two studies reported similar postvisit outcomes between remote and in-person visits. Twenty-four studies reported a combination of patient and provider opinions toward telemedicine. Of 9834 patients and 116 providers, 82.4% and 65.2% were satisfied overall with telemedicine, respectively. Of 3526 patients and 168 providers, 57.0% and 66.5% preferred telemedicine to in-person visits, respectively. CONCLUSIONS Overall, most patients and providers have a high opinion of telemedicine for outpatient visits, and increasing evidence suggests that remote visits yield favorable clinical outcomes. The high rates of patient and provider satisfaction and preference may be considered for further adoption of remote neurosurgical visits beyond the COVID-19 era.
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Affiliation(s)
- Jeffrey Z Nie
- Southern Illinois University School of Medicine, Springfield, Illinois, USA.
| | - Constantine L Karras
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Pavlos Texakalidis
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - S Joy Trybula
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nader S Dahdaleh
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Riew GJ, Iyer S. Response to Letter to the Editor "Telemedicine in Spine Surgery During COVID-19". Global Spine J 2022; 12:1985. [PMID: 36271633 PMCID: PMC9596679 DOI: 10.1177/21925682211041616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Bovonratwet P, Song J, Kim YE, Shinn D, Morse KW, Dowdell JE, Huang RC, Albert TJ, Sandhu HS, Qureshi SA, Iyer S. Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients. Spine (Phila Pa 1976) 2022; 47:1194-202. [PMID: 35797655 DOI: 10.1097/BRS.0000000000004387] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/24/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A Retrospective cohort study. OBJECTIVE To (1) assess whether diagnoses and surgical plans established during a new patient telemedicine visit changed following an in-person evaluation and (2) determine any differences in perioperative outcomes between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. SUMMARY OF BACKGROUND DATA Data on capability of telemedicine to deliver high-quality preoperative assessment without a traditional in-person interaction and physical examination is lacking. MATERIALS AND METHODS Records of patients who had a new patient telemedicine visit and indicated for surgery with documented specific diagnosis as well as surgical plans from a spine department at an urban tertiary center from April 2020 to April 2021 were reviewed. For a subset of patients that had a follow-up in-person evaluation before surgery, these diagnoses and plans were compared. Perioperative outcomes were compared between patients who only had a telemedicine visit before surgery versus those who had a telemedicine visit followed by an in-person evaluation before surgery. RESULTS A total of 166 patients were included. Of these, 101 patients (61%) only had a new patient telemedicine visit before surgery while 65 (39%) had a telemedicine visit followed by an in-person evaluation. There were no differences in the rate of case cancellations before surgery and patient-reported outcome measures between these two groups ( P >0.05). Of 65 patients who had both a telemedicine followed by an in-person visit, the diagnosis was unchanged for 61 patients (94%) and the surgical plan did not change for 52 patients (80%). The main reason for surgical plan change was due to updated findings on new imaging, 10 patients, (77%). CONCLUSIONS The current study suggests that telemedicine evaluations can provide an effective means of preoperative assessment for spine patients. LEVEL OF EVIDENCE Level 3.
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Rispoli R, Cappelletto B. Telemedicine in practice: Patient selection and strategies adopted in spinal care during the COVID-19 era and beyond. Surg Neurol Int 2022; 13:383. [PMID: 36128140 PMCID: PMC9479600 DOI: 10.25259/sni_638_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 08/04/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
The SARS-CoV-2 (COVID-19) pandemic has had a substantial effect on health-care systems around the world. To deal with this challenge, we developed a prospectus design and test a teleconsultation procedure suitable for both diagnostic and therapeutic needs of outpatients in our Spine and Spinal Cord Surgery Units.
Methods:
(1) The first 15 patients received in-person and telemedicine visits: Our pilot began with screening protocol that involved 15 patients who received an in-person assessment and a telemedicine consult. The 15 patients who were selected were already known to our unit after having had at least one previous in-person visit. Further, they had to be neurologically intact or have a stable neurological examination. The secondary teleconsultation took place as a synchronous face-to-face communication between the doctor and the patient through a video interface (Lifesize Video Conferencing, Austin, Texas). If the patient demonstrated worsening of symptoms or of their condition, they were rescheduled for an immediate/timely in-person revisit with a spinal physician. (2) Fifty patients were offered telemedicine visits alone: 35 accepted: Next, from 2020 to 2021, we provided a questionnaire to 50 patients, we deemed eligible for teleconsultations: 35 agreed to the teleconsultations, while 15 refused (i.e., selecting direct in-person assessments).
Results:
We found a comparable quality for the clinical consultations/assessments provided in-person versus through telemedicine. Further, the additional 35 patients who were positively impressed with the quality of the medical care provided utilizing the telemedicine/remote visits alone.
Conclusion:
When pandemic conditions worsen, telemedicine appears to be a viable and important tool/ alternative for spinal surgeons to screen potential patients for treatment/surgery. This preliminary study suggests that a remote examination may be effective, particularly in patients who have previously undergone prior in-person evaluations.
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Greven ACM, McGinley BM, Nakirikanti AS, Couceyro JD, Malcolm JG, Rodts GE, Refai D, Gary MF. Telemedicine in Spine Surgery: Outcomes for 138 Patients With Virtual Preoperative Assessment Compared to Historical Controls. World Neurosurg 2022; 161:e495-e499. [PMID: 35189421 DOI: 10.1016/j.wneu.2022.02.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION COVID-19 has accelerated the use of telemedicine in all aspects of health care delivery, including initial surgical evaluation. No existing literature investigates the safety and efficacy of telemedicine to preoperatively evaluate spine surgery candidates. Our objectives were: (1) Compare the change in visual analogue scale (VAS) scores between the telemedicine preoperative visit and in-person preoperative visit groups. (2) Compare the average surgical time, estimated blood loss (EBL), length of hospital stay (LOS), rates of intraoperative complications, rates of readmission, and rates of reoperation between the telemedicine preoperative visit and in-person preoperative visit groups. METHODS The previously stated metrics were collected for 276 patients, 138 who were exclusively evaluated preoperatively with telemedicine and 138 historical controls who were evaluated preoperatively in person. We used χ2 and independent samples t tests to determine significance. RESULTS There were no significant differences in the mean change in VAS scores (-2.7 ± 3.1 telemedicine vs. -2.2 ± 3.7 in-person, P = 0.317), mean percentage change in VAS scores (-40.5% ± 54.3% vs. -39.5% ± 66.6%, P = 0.811), mean surgical time (2.4 ± 1.4 hours vs. 2.3 ± 1.3 ours, P = 0.527), mean EBL (150.4 ± 173.3 mL vs. 156.7 ± 255.0 mL, P = 0.811), mean LOS (3.3 ± 2.4 days vs. 3.3 ± 2.5 days, P = 0.954), intraoperative complication rates (0.7% vs. 1.4%, P = 0.558), reoperation rates (7.9% vs. 4.3%, P = 0.208), or readmission rates (10.1% vs. 5.1%, P = 0.091) between the telemedicine preoperative visit and in-person preoperative visit groups. CONCLUSIONS Preoperative evaluation via telemedicine leads to the same short-term surgical outcomes as in-person evaluation with no increased risk of surgical complications.
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Affiliation(s)
| | | | | | | | | | - Gerald E Rodts
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Daniel Refai
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Matthew F Gary
- Emory University School of Medicine, Atlanta, Georgia, USA
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Glinkowski WM. Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown-Individual Observation. Int J Environ Res Public Health 2022; 19:5418. [PMID: 35564814 PMCID: PMC9103315 DOI: 10.3390/ijerph19095418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/10/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has caused a substantial intensification of the telemedicine transformation process in orthopedics since 2020. In the light of the legal regulations introduced in Poland, from the beginning of the SARS-CoV-2 pandemic, physicians, including orthopedic surgeons, have had the opportunity to conduct specialist teleconsultations. Teleconsultations increase epidemiological safety and significantly reduce the exposure of patients and medical staff to direct transmission of the viral vector and the spread of infections. The study aimed to describe diagnoses and clinical aspects of consecutive orthopedic teleconsultations (TC) during the pandemic lockdown. The diagnoses were set according to the International Classification of Diseases (ICD-10). Hybrid teleconsultations used smartphones and obligatory Electronic Health Record (EHR) with supplemental voice, SMS, MMS, Medical images, documents, and video conferencing if necessary. One hundred ninety-eight consecutive orthopedic teleconsultations were served for 615 women and 683 men (mean age 41.82 years ± 11.47 years). The most frequently diagnosed diseases were non-acute orthopedic disorders "M" (65.3%) and injuries "S" (26.3%). Back pain (M54) was the most frequent diagnosis (25.5%). Although virtual orthopedic consultation cannot replace an entire personal visit to a specialist orthopedic surgeon, in many cases, teleconsultation enables medical staff to continue to participate in providing medical services at a sufficiently high medical level to ensure patient and physician. The unified approach to TC diagnoses using ICD-10 or ICD-11 may improve further research on telemedicine-related orthopedics repeatability. Future research directions should address orthopedic teleconsultations' practical aspects and highlight legal, organizational, and technological issues with their implementations.
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Affiliation(s)
- Wojciech Michał Glinkowski
- Center of Excellence “TeleOrto” for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00-581 Warsaw, Poland;
- Polish Telemedicine and eHealth Society, 03-728 Warsaw, Poland
- Gabinet Lekarski, 03-728 Warsaw, Poland
- Centrum Medyczne PZU Zdrowie, 02-715 Warsaw, Poland
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Meng G, McAiney C, Perlman CM, McKillop I, Tisseverasinghe T, Chen HH. Service process factors affecting patients' and clinicians' experiences on rapid teleconsultation implementation in out-patient neurology services during COVID-19 pandemic: a scoping review. BMC Health Serv Res 2022; 22:534. [PMID: 35459134 PMCID: PMC9026006 DOI: 10.1186/s12913-022-07908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background The adoption of teleconsultation for outpatient neurology services was limited until the onset of the COVID-19 pandemic which forced many outpatient neurology services to rapidly switch to virtual models. However, it remains unclear how this change has impacted patients’ and clinicians’ perceptions of service quality. The purpose of this scoping review is to identify process factors that influence patients’ and clinicians’ experiences of outpatient teleconsultation services during COVID-19. Methods Arksey and O’Malley scoping review framework was used to search PubMed, Scopus, CINAHL, and PsycInfo for original peer-reviewed research studies that examined the experiences of synchronous teleconsultation between a clinician and patient in a home-setting since the World Health Organization announced the COVID-19 global pandemic. The service quality model SERVQUAL was used to conduct a deductive thematic analysis to identify the key factors that impacted the patients’ and clinicians’ perception of teleconsultation services. Results A total of nineteen studies published between January 1, 2020, and April 17, 2021, were identified. The most common service process factors affecting the patients’ and clinicians’ experiences of teleconsultation were technical issues, addressing logistical needs, communication, ability to perform clinical activities, appropriate triage, and administrative support. Conclusions Our findings identified six key service process factors affecting the patients’ and clinicians’ teleconsultation experiences in outpatient neurology services. The need for improvement of triage process and standardizing administrative virtual care pathway are identified as important steps to improve patients and clinicians’ teleconsultation experiences compared to pre-COVID era. More research is needed to assess outpatient neurology teleconsultation service quality from patients’ and clinicians’ perspectives. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07908-4.
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Affiliation(s)
- Guangxia Meng
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Christopher M Perlman
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Ian McKillop
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | | | - Helen H Chen
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
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Owolabi EO, Mac Quene T, Louw J, Davies JI, Chu KM. Telemedicine in Surgical Care in Low- and Middle-Income Countries: A Scoping Review. World J Surg. [PMID: 35428920 PMCID: PMC9012517 DOI: 10.1007/s00268-022-06549-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 12/11/2022]
Abstract
Background Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking. Aim To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs. Methods This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021. Results A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region (n = 73; 41.0%) and of these, most were from China (n = 69; 94.5%). The most common telemedicine platforms used were telephone call (n = 71, 39.9%), video chat (n = 42, 23.6%) and WhatsApp/WeChat (n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up (n = 71, 39.9%), patient education (n = 32, 18.0%), provider training (n = 28, 15.7%) and provider-provider consultation (n = 16, 9.0%). Less than a third (n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes. Conclusion Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s00268-022-06549-2.
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Diaz-Miron J, Ogle S, Kaizer A, Acker SN, Rove KO, Inge TH. Surgeon, patient, and caregiver perspective of pediatric surgical telemedicine in the COVID-19 pandemic era. Pediatr Surg Int 2022; 38:241-248. [PMID: 34550442 PMCID: PMC8456071 DOI: 10.1007/s00383-021-05016-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Adoption of telemedicine (TME) in surgical specialties, prior to the COVID-19 pandemic, has previously been slow. The purpose of this prospective, observational, single institution study is to evaluate surgeon and caregiver perspectives of TMEs during the pandemic. METHODS Surveys were distributed to surgical faculty regarding perceptions of TME early during the pandemic and 2 months later. Caregivers (or patients > 18 years old) were asked after each TME to complete a survey regarding perceptions of TMEs. RESULTS Surveys were distributed to 73 surgeons. Response rates were 71% initially and 63% at follow-up. Sixty-eight percent reported no prior TME experience. No significant differences were noted in the overall satisfaction. An inverse relationship between surgeon age and satisfaction at the follow-up survey was identified (p = 0.007). Additional surveys were distributed to 616 caregivers or patients (response rate 13%). Seventy-two percent reported no prior experience with TME and 79% described TME as similar to an in-person visit. Audiovisual satisfaction of the TME was higher in greater income households (p = 0.02). CONCLUSIONS Pre-pandemic experience with TME was low in both groups; however, experiences were perceived as satisfactory. Positive experiences with TME may encourage increased utilization in the future, although demographic variations may impact satisfaction with TME. TRIAL REGISTRATION Unique identifier NCT04376710 at Clinicaltrials.gov (5/6/2020).
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Affiliation(s)
- Jose Diaz-Miron
- Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado, 13123 E 16th Ave, B323, Aurora, CO, 80045, USA.
| | - Sarah Ogle
- Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado, 13123 E 16th Ave, B323, Aurora, CO, 80045, USA
| | - Alex Kaizer
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Shannon N Acker
- Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado, 13123 E 16th Ave, B323, Aurora, CO, 80045, USA
| | - Kyle O Rove
- Department of Pediatric Urology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E. 16th Ave, Aurora, CO, 80045, USA
| | - Thomas H Inge
- Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado, 13123 E 16th Ave, B323, Aurora, CO, 80045, USA
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Affiliation(s)
- Morgan Angotti
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - G. Michael Mallow
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Arnold Wong
- International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA,Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Scott Haldeman
- World Spine Care, Santa Ana, CA, USA,Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada,Department of Neurology, University of California, Irvine, CA, USA
| | - Howard S. An
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Dino Samartzis
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA,Dino Samartzis, Department of Orthopaedic Surgery, Rush University Medical Center, Orthopaedic Building, Suite 204-G, 1611 W. Harrison Street, Chicago, IL 60612, USA.
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Mazarakis NK, Koutsarnakis C, Komaitis S, Drosos E, Demetriades AK. Reflections on the future of telemedicine and virtual spinal clinics in the post COVID-19 era. Brain and Spine 2022; 2:100930. [PMID: 36248094 PMCID: PMC9375852 DOI: 10.1016/j.bas.2022.100930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/20/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
Both patients and surgeons seem to show significant satisfaction with virtual spinal clinics. Virtual spinal clinics may be an important adjunct to traditional face-to-face clinics. Limitations in physical examination constitute main concern. Patient selection is an important factor in deciding who is a suitable candidate for a virtual spinal clinic. Medicolegal concerns need to be adequately addressed if spinal virtual clinics are to be routinely used.
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Noutsios CD, Boisvert-Plante V, Laberge E, Perez J, Ingelmo P. The Telemedicine-Based Pediatric Examination of the Back and Lower Limbs: A Narrative Review. J Pain Res 2021; 14:2959-2979. [PMID: 34584449 PMCID: PMC8464344 DOI: 10.2147/jpr.s329173] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/03/2021] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic has accelerated the transition to virtual healthcare while also prompting an abundance of new literature highlighting telemedicine's capabilities and limitations for various medical applications, notably musculoskeletal examinations. Telemedicine provides an opportunity to deliver timely patient- and family-centred care while maintaining physical distancing and improving access to remote communities. This review aims to narrate the current state of the literature on telemedicine applied in the context of a musculoskeletal examination for children aged 3 to 18 years. The PubMed and ScienceDirect databases were searched for relevant articles from January 2015 to August 2021 using a combination of keywords and nested searches. The general examination components relevant to the back and lumbosacral spine, hip, knee, ankle/foot, and gait are described. These components include inspection, palpation, range of motion, motor, and sensory examination as well as special testing. There is general feasibility, validity, and substantial reliability in performing most examination components, and primary diagnoses established virtually were found to be either the same or similar in the vast majority of cases. Despite the current literature focusing mainly on adult populations, we describe how each aspect of the exam can be reliably incorporated into a virtual appointment specific to the pediatric population. Currently available smartphone-based applications that measure joint range of motion were generally found to have high reliability and validity. Caregivers are needed for most of the consultation, especially in younger children, but select physical exam maneuvers can be self-performed by older children and adolescents alone. By providing an overview of the available smartphone tools as well as the reliability and validity of remote assessments, this review not only establishes a foundation for a structured pediatric musculoskeletal examination, but also aims to increase providers' confidence in incorporating telemedicine into their practice.
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Affiliation(s)
| | | | - Erika Laberge
- Edward’s Family Interdisciplinary Centre for Pediatric Complex Pain, Montreal Children’s Hospital (McGill University Health Centre), Montreal, QC, Canada
| | - Jordi Perez
- Alan Edwards Pain Management Unit, Montreal General Hospital (McGill University Health Centre), Montreal, QC, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
| | - Pablo Ingelmo
- Edward’s Family Interdisciplinary Centre for Pediatric Complex Pain, Montreal Children’s Hospital (McGill University Health Centre), Montreal, QC, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal, QC, Canada
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