BACKGROUND: Telemedicine in surgery holds promise for improving access and decreasing costs, but its role remains ill-defined. This pilot study was performed to investigate the safety, feasibility, and financial implications of providing postoperative care using an electronic clinic (eClinic) at a university hospital. METHODS: An easy-to-use and secure eClinic platform was constructed in Epic (Epic Systems Corporation, Verona, WA). Patients undergoing laparoscopic cholecystectomy, appendectomy, and hernia repairs on an adult acute care surgery service were enrolled in this program over an 11-month period (March 2017 to January 2018). Patients with prolonged hospitalizations (greater than 4 nights), perioperative complications, drains, and open wounds were excluded. Demographics, clinical outcomes, encounter time, patient satisfaction survey results, and cost analysis were compared with the traditional clinic (tClinic) patient population. RESULTS: Two hundred thirty-three eligible patients (61% female; mean age 41 ± 16 years) were enrolled in this program. Their demographics were no different than the tClinic. Frequencies of readmission, reoperation, and emergency department visits (2.7%, 0%, and 4.2%, respectively) in the eClinic group were also similar to the tClinic group. However, total visit time was significantly shorter in the eClinic group (14 vs 145 minutes, P < 0.01). Anonymous surveys demonstrated a high degree of satisfaction, with 85% of patients expressing desire to utilize the eClinic again. This program enhanced the capacity for new visits to tClinic, with a resultant projected increase in additional operative cases and revenue for the health care system. CONCLUSIONS: A safe and efficient postoperative telemedicine program can be constructed utilizing a widely available electronic medical record system, which can improve patient satisfaction, optimize throughput, and increase gross charges for the healthcare system.
BACKGROUND: Telemedicine in surgery holds promise for improving access and decreasing costs, but its role remains ill-defined. This pilot study was performed to investigate the safety, feasibility, and financial implications of providing postoperative care using an electronic clinic (eClinic) at a university hospital. METHODS: An easy-to-use and secure eClinic platform was constructed in Epic (Epic Systems Corporation, Verona, WA). Patients undergoing laparoscopic cholecystectomy, appendectomy, and hernia repairs on an adult acute care surgery service were enrolled in this program over an 11-month period (March 2017 to January 2018). Patients with prolonged hospitalizations (greater than 4 nights), perioperative complications, drains, and open wounds were excluded. Demographics, clinical outcomes, encounter time, patient satisfaction survey results, and cost analysis were compared with the traditional clinic (tClinic) patient population. RESULTS: Two hundred thirty-three eligible patients (61% female; mean age 41 ± 16 years) were enrolled in this program. Their demographics were no different than the tClinic. Frequencies of readmission, reoperation, and emergency department visits (2.7%, 0%, and 4.2%, respectively) in the eClinic group were also similar to the tClinic group. However, total visit time was significantly shorter in the eClinic group (14 vs 145 minutes, P < 0.01). Anonymous surveys demonstrated a high degree of satisfaction, with 85% of patients expressing desire to utilize the eClinic again. This program enhanced the capacity for new visits to tClinic, with a resultant projected increase in additional operative cases and revenue for the health care system. CONCLUSIONS: A safe and efficient postoperative telemedicine program can be constructed utilizing a widely available electronic medical record system, which can improve patient satisfaction, optimize throughput, and increase gross charges for the healthcare system.
Authors: Zhi Ven Fong; Daniel A Hashimoto; Ginger Jin; Alex B Haynes; Numa Perez; Motaz Qadan; Cristina R Ferrone; Carlos Fernandez-Del Castillo; Andrew L Warshaw; Keith D Lillemoe; Lara N Traeger; David C Chang Journal: Ann Surg Date: 2021-08-01 Impact factor: 12.969
Authors: Serena M Taylor; Maria T Schwabe; Gail Pashos; Tanner Thorton; Jeffrey J Nepple; Charles M Lawrie; John C Clohisy Journal: Iowa Orthop J Date: 2021-12
Authors: David S Portney; Rohan Ved; Vahagn Nikolian; Andrea Wei; Tom Buchmueller; Brad Killaly; Hasan B Alam; Chad Ellimoottil Journal: Mhealth Date: 2020-10-05
Authors: Michael T Kemp; Aaron M Williams; Craig S Brown; Daniel R Liesman; Sriganesh B Sharma; Glenn K Wakam; Ben E Biesterveld; Jesse K Wilson; Mark S Cohen; Hasan B Alam Journal: Ann Surg Date: 2021-06-01 Impact factor: 13.787
Authors: T Adesoye; C H Davis; H Del Calvo; A F Shaikh; V Chegireddy; E Y Chan; S Martinez; K Y Pei; F Zheng; N Tariq Journal: J Surg Educ Date: 2020-07-01 Impact factor: 2.891