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Vanderbilt Study Finds Value in Pre-Surgery Telehealth Consults

Analysis  |  By Eric Wicklund  
   January 20, 2023

The study found that virtual visits have the same value as in-person visits for communication and shared decision-making. And they're more convenient.

A new study out of Vanderbilt University finds that a telehealth platform is as effective as an in-person meeting for patients who are checking in with their care teams prior to surgery.

The study, published in the Journal of the American College of Surgeons (JACS) and presented at the Southern Surgical Association's Annual Meeting in December 2022, reinforces the notion that a virtual platform can replace an in-person meeting for shared decision-making and communication, as long as no hands-on services are required.

These virtual visits soared during the pandemic, when health systems shifted as many non-crucial services as possible from in-person meetings to telehealth. They've also become popular with patients who would have to take time off from work or travel to those appointments and providers who could better fit virtual meetings into their workflows.

According to the study of 387 patients participating in first-time pre-surgery visits between May 2021 and June 2022 at Vanderbilt University Medical Center clinics in Nashville, those who used telehealth and those who visited the clinic reported high levels of quality communication with their care teams. Those using telehealth cited convenience and usefulness as benefits, while negative comments were focused on technical difficulties and an inability to be in the same room with the doctor.

“We see patients that live hours away. When the COVID-19 pandemic hit, it threw fuel on the fire of our telehealth program,” Alexander T. Hawkins, MD, MPH, FACS, an associate professor of surgery at VUMC and co-author of the study, said in a press release. “Across the entire healthcare system, we now do about 20,000 telehealth visits a month. Previously, there had been concerns about whether we could effectively communicate with patients remotely, but we found that patients are just as satisfied with telehealth visits as in-person appointments.”

“We believe these results suggest that either method, in-person or telehealth, is appropriate," he added. "Ultimately, it very much depends upon what the surgeon and the patient think is the best way to communicate. Going forward, we need to determine what is most appropriate for telehealth, and what is most appropriate for in-person visits. The data we generated in this study do give folks support, so that if they prefer telehealth appointments, they can be confident that they will not be sacrificing quality of communication or shared decision-making.”

Some surgeons involved in the study said telehealth should not be used for first-time visits, when patient and provider are establishing a relationship, but would be appropriate for follow-up visits that do not involve hands-on care. Telehealth advocates have long argued that point, saying and audio-visual platform can be just as effective in establishing a provider-patient relationship as an in-person meeting.

The next step, researchers said, would be to create protocols for when telehealth is appropriate for pre-surgery consults, and when an in-person visit is recommended.

Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.


KEY TAKEAWAYS

Researchers at Vanderbilt University Medical Center compared first-time virtual visits with in-person visits for more than 300 patients scheduled for surgery between May 2021 and June 2022.

They found no difference in satisfaction levels for the two groups in communication and shared decision-making.

Those using telehealth gave the platform high marks for usefulness and convenience, while concerns were focused on technical issues and not being in the same room as a doctor.


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