Patients upload photos of their incisions for doctor inspection.
Researchers wondering whether surgery patients would like follow-up care online got a definite yes in a study designed to answer that question.
The study is another step forward in the attempt to integrate telemedicine into the maintenance of your health. The main goal is to cut costs by reducing in-person visits while providing you with the comfort of your own home during follow-up.
The study included 50 patients who had either gallbladder removal or hernia repair procedures. Seventy-six percent of this group said online visits were “acceptable” as the only form of follow-up care.
Further, the surgeons conducting the study said that, for 68 percent of patients, online and in-person visits were equally effective. That was an indication, they added, that offering an option for online care may have largely impacted patient preferences.
The patients sent online photos of their incisions to their doctors along with symptom reports. Surgeons then responded to patients about their symptom reports and wound images.
The surgeon and patient did not need to be online at the same time, uploading and accessing information at their own convenience.
The research team thought there might be a role for moving some postoperative care online. They wanted to test their theory on patients who had relatively simple procedures, said lead author Kristy Kummerow Broman, MD, MPH, resident physician in general surgery at Vanderbilt University Medical Center.
“To date, there has been minimal incorporation of these new care delivery modalities into general surgical care, and patients have been less frequently relied upon to generate their own data in the form of digital images,” the study authors wrote.
Kummerow Broman also stressed that the online follow-up might not be appropriate for you if your surgery was more complicated and in-person postoperative assessments would be needed.
“Some operations simply require an in-person assessment,” she said. The Vanderbilt doctors want to continue designing and testing the right tools for online care.
At the same time, though, they want to develop standards that would determine whether you would be a good candidate for online assessment or whether in-person follow up would be needed.
The study was designed only to measure patient acceptance, not safety or quality of care, Kummerow Broman said. “We wanted to first establish whether this method is something that patients wanted. Now that we feel we have done so, we are continuing our research in this area (to try and) develop ways to measure safety and quality.”
Telemedicine still has a long way to go before you see it used routinely by your doctors, but it has also come a long way in the past several years.
Previous studies have shown that telemedicine including online assessment can significantly cut health-related travel time for you.
Emory University’s transplant center has used online patient-doctor visits for several years via “telehealth centers” that are part of a statewide network.
While the visits aren’t home based, they do save patients who have had transplant surgery many hours of drive time. When the transplant center looked at 41 transplant patients over a two-year period, staff determined that patients saved about 9,400 miles in drive time.
Telehealth has also proven useful for end-of-life, or palliative, care, but lack of coverage for the costs remains a major barrier. The regulatory climate on telemedicine also has been a jumble, but is improving as Congress addresses its use.
Primary care physicians have been reluctant to incorporate telemedicine, including online interfaces, into their practices because they “worry that the rapidly-growing field… is just too complicated and time-consuming,” according to Medical Economics magazine.
But physicians who are using telemedicine say “there is no need to reinvent the wheel or spend a fortune to jump in on a trend that many believe will improve patient health.”
March 31, 2020
Janet O’Dell, RN