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Nathan Graden BS, Kelsey L. Wise MD, Kelly Edwards BS, Melissa Albersheim MD, Benjamin R Williams MD, Amy Gravely MA, V.F. Sechriest II MD
Background
Telemedicine may be effectively utilized for
routine care of postoperative patients, offering
improved driving distance, wait times, and cost
savings. During the COVID-19 pandemic, when
limiting in-person visits became a priority,
Minneapolis VA Medical Center (VAMC)
orthopedic staff replaced scheduled clinic visits
with phone-calls for patients who had recently
undergone joint replacement surgery.
Next Steps
Methods
Discussion
High Satisfaction with Telehealth for Arthroplasty
Post-operative Care at the Minneapolis VAMC
Results
References
Insert logo here –align with the side of the
text box below. Higher dpi = better results
Adoption of orthopedic telehealth has demonstrated
substantial positive impact for patients and for the
Minneapolis VAMC. Telehealth may be a useful
alternative for routine post-operative care following
arthroplasty, even beyond the COVID-19 pandemic.
Patient impact:
✓Decreased travel burden
✓Decrease financial burden
✓Decrease chance of disease transmission
✓Increased patient access to orthopedic clinic
VAMC Impact
✓New Initiative →Orthopedic video triage for
community care partners
✓More patients served locally and regionally
✓Resource frugality (postoperative X-rays)
Lasting Impact
Monthly telehealth visits increased by 285% from
2019 to 2020. In 2021, telehealth visits continue to
be 200% of their pre-pandemic volume. (Figure 4.)
•Develop a scheduling protocol tailored towards
patients likely to benefit most from postoperative
telehealth.
•After demonstrating the advantages and feasibility
of orthopedic telehealth, funding was approved for
a virtual referral center, combining an Ortho
Hotline and a virtual health on-demand service.
Figure 1. Reasons cited for keeping the in-person
postoperative appointment.
Purpose
➢The purpose of this study was two-fold:
1. Evaluate satisfaction of telehealth as an
alternative to in-person postop visits
2. Identify risk factors for lower satisfaction with
telehealth
➢We hypothesized that Patients would be as
satisfied or more satisfied with telehealth visits
compared to in-person visits.
A total of 140 patients were contacted; Three
declined participation; One could not be reached.
Demographic data for the remaining 136 patients is
in Table 1.
Most patients (92.7%) were satisfied (n=67) or very
satisfied (n=48) with the post-operative phone visit.
Only Charlson Comorbidity Index was significantly
associated with low satisfaction. (Table 2). There
were few patients with low satisfaction, limiting
characterization of patients at high risk for low
satisfaction. (Table 2)
Notably, satisfaction with the postop phone visit was
NOT significantly correlated with the following as
hypothesized:
oPatient residence distance from the VA
oPatients’ number of psychiatric co-morbidities
oPatients’ employment/disability status
oPatients’ living situation (alone or with others)
Forty-four patients (31.4%) requested an in-person
visit after their phone call (reasons cited in Figure 1),
while 96 patients (68.6%) felt telehealth was sufficient. Figure 4. Monthly Telehealth Appointments
1 Ellimoottil C, Boxer RJ. Bringing Surgical Care to the Home Through
Video Visits. JAMA Surg 2018;153:177-8.
2 Hwa K, Wren SM. Telehealth follow-up in lieu of postoperative clinic visit
for ambulatory surgery: results of a pilot program. JAMA Surg
2013;148:823-7.