Smith Ariella J, Pfister Benjamin F, Woo Elise W Y, Walters Benjamin J, Blacket Benedict, Page Nicholas, Drobetz Herwig
Department of Orthopaedic Surgery, Lismore Base Hospital, Lismore, New South Wales, Australia.
ANZ J Surg. 2020 Nov;90(11):2237-2241. doi: 10.1111/ans.16339. Epub 2020 Sep 25.
The coronavirus disease outbreak in December 2019 rapidly spread around the world with profound effects on healthcare systems. In March 2020, all elective surgery and elective outpatient clinics were cancelled in our institution, a regional hospital in Northern New South Wales, Australia. With regard to orthopaedic fracture clinics, a telehealth system was implemented on an emergency basis for patient and staff safety to prevent disease transmission. The aim of our study was to investigate whether rapid implementation of telehealth for orthopaedic fracture clinics resulted in an increase in complications.
A retrospective cohort study of all patients with orthopaedic fracture clinic appointments at a regional New South Wales hospital between 17 March and 8 May 2020 was undertaken. There were 191 patients, including 390 appointments of which 23.1% were conducted via telehealth, namely by phone call. Complications requiring phone calls to the orthopaedic team, presentations to the emergency department, admission to hospital or return to theatre, were recorded.
There was no increase in complications following emergent implementation of telehealth for orthopaedic fracture clinic follow-up in our institution. Patients in the telehealth group were significantly older than those in the clinic group.
The study demonstrates that application of telehealth fracture clinics in a regional Australian setting can be achieved without increasing complication rates and can be used to formulate a rapid telehealth implementation plan if a similar scenario occurs in the future.
2019年12月爆发的冠状病毒病迅速在全球蔓延，对医疗系统产生了深远影响。2020年3月，在我们位于澳大利亚新南威尔士州北部的一家地区医院，所有择期手术和择期门诊均被取消。对于骨科骨折门诊，出于患者和工作人员安全考虑，紧急实施了远程医疗系统以防止疾病传播。我们研究的目的是调查骨科骨折门诊快速实施远程医疗是否会导致并发症增加。
对2020年3月17日至5月8日期间在新南威尔士州一家地区医院预约骨科骨折门诊的所有患者进行回顾性队列研究。共有191名患者，包括390次预约，其中23.1%是通过远程医疗进行的，即通过电话。记录了需要致电骨科团队、前往急诊科就诊、住院或返回手术室的并发症情况。
在我们机构中，骨科骨折门诊随访紧急实施远程医疗后，并发症没有增加。远程医疗组的患者明显比门诊组的患者年龄大。
该研究表明，在澳大利亚地区环境中应用远程医疗骨折门诊可以在不增加并发症发生率的情况下实现，并且如果未来出现类似情况，可用于制定快速的远程医疗实施计划。
