Telemedicine Visits Can Generate Highly Accurate Diagnoses and Surgical Plans for Spine Patients.

Overview

abstract

STUDY DESIGN: 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 prior to surgery versus those who had a telemedicine visit followed by an in-person evaluation prior to surgery. SUMMARY OF BACKGROUND DATA: Data on capability of telemedicine to deliver high-quality preoperative assessment without a traditional in-person interaction and physical exam is lacking. 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 - April 2021 were reviewed. For a subset of patients that had a follow-up in-person evaluation prior to surgery, these diagnoses and plans were compared. Perioperative outcomes were compared between patients who only had a telemedicine visit prior to surgery versus those who had a telemedicine visit followed by an in-person evaluation prior to surgery. RESULTS: A total of 166 patients were included. Of these, 101 patients (61%) only had a new patient telemedicine visit prior to surgery while 65 (39%) had a telemedicine visit followed by an in-person evaluation. There were no differences in the rate of case cancellations prior to 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: 3.