1 Department of Orthopaedic Surgery, University Hospital of North Norway, Tromsø, Norway.
2 Centre for Quality Improvement and Development, University Hospital of North Norway, Tromsø, Norway.
J Telemed Telecare. 2019 Sep;25(8):451-459. doi: 10.1177/1357633X18783921. Epub 2018 Jul 4.
Decentralised services through outreach clinics or modern technology reduce patient travel time and cost to society. Telemedicine consultation through videoconference is one such modality. Here, we compared patient-reported health outcomes and satisfaction between video-assisted remote and standard face-to-face orthopaedic consultations.
This randomised controlled trial included two parallel groups: (1) patients receiving video-assisted remote consultation at a regional medical centre (RMC); and (2) patients receiving standard consultation at the orthopaedic outpatient clinic of the University Hospital of North Norway (UNN). This study included patients referred to or scheduled for a consultation at the orthopaedic outpatient clinic. After each consultation, patient satisfaction was determined using patient-completed questionnaires containing questions on patient-reported health (three-level European quality of life five-dimension index (EQ-5D-3L)/European quality of life visual analogue scale (EQ-VAS)) and questions from a validated OutPatient Experiences Questionnaire (OPEQ).
This study included 389 patients, of which 199 received remote consultation and 190 received standard consultation (total of 559 consultations). In all, 99% RMC-randomised patients and 99% UNN-randomised patients evaluated the consultation as very satisfactory or satisfactory. Moreover, 86% RMC-randomised patients preferred video-assisted consultation as the next consultation. No difference was observed in patient-reported health after 12 months between the two groups. EQ-5D index scores were 0.77 and 0.75 for RMC- and UNN-randomised patients, respectively ( = 0.42).
We did not observe any difference in patient-reported satisfaction and health (EQ-5D/EQ-VAS) between video-assisted and standard consultations, suggesting that video-assisted remote consultation can be safely offered to some orthopaedic patients. Moreover, a significantly high proportion of patients selected video-assisted remote consultation as their next consultation, thus strengthening the findings of this study. However, economic aspects should be assessed before widely recommending video-assisted consultation.
通过外展诊所或现代技术提供的分散服务可减少患者的旅行时间和社会成本。视频会议形式的远程医疗咨询就是这样一种模式。在此，我们比较了通过视频辅助远程和标准面对面骨科咨询获得的患者报告的健康结果和满意度。
本随机对照试验纳入了两个平行组：（1）在区域医疗中心（RMC）接受视频辅助远程咨询的患者；（2）在挪威北特伦德拉格大学医院（UNN）骨科门诊接受标准咨询的患者。该研究纳入了转诊或预约骨科门诊就诊的患者。每次咨询后，患者满意度通过患者完成的问卷确定，问卷中包含患者报告的健康问题（欧洲五维健康量表 3 级简表（EQ-5D-3L）/欧洲五维健康量表视觉模拟评分（EQ-VAS））和经过验证的门诊患者体验问卷（OPEQ）的问题。
该研究共纳入 389 名患者，其中 199 名接受远程咨询，190 名接受标准咨询（共 559 次咨询）。RMC 随机分组的患者中，99%和 UNN 随机分组的患者中，99%均评价咨询为非常满意或满意。此外，86%RMC 随机分组的患者更希望视频辅助咨询作为下一次就诊。两组患者在 12 个月时的患者报告健康状况无差异。RMC 随机分组患者的 EQ-5D 指数评分为 0.77，UNN 随机分组患者的 EQ-5D 指数评分为 0.75（ = 0.42）。
我们没有观察到视频辅助咨询和标准咨询之间在患者报告的满意度和健康（EQ-5D/EQ-VAS）方面存在差异，这表明视频辅助远程咨询可以安全地提供给一些骨科患者。此外，有相当大比例的患者选择视频辅助远程咨询作为他们的下一次就诊，这进一步证实了本研究的结果。然而，在广泛推荐视频辅助咨询之前，应评估其经济方面。
