Section of Endocrine Surgery, Department of Surgery, University of California Los Angeles David Geffen School of Medicine, CA.
Section of Endocrine Surgery, Department of Surgery, University of California Los Angeles David Geffen School of Medicine, CA.
Surgery. 2021 May;169(5):1139-1144. doi: 10.1016/j.surg.2020.11.019. Epub 2020 Dec 28.
In response to the coronavirus 2019 pandemic, telemedicine use has increased throughout the United States. We aimed to measure patient experience with electronic health record-integrated postoperative telemedicine encounters following thyroid and parathyroid surgery.
In this preliminary study, adult patients receiving postoperative electronic health record-integrated telemedicine video encounters or standard in-person visits after thyroid or parathyroid surgery at a single institution were prospectively enrolled from November 2019 through May 2020. Patients with home zip codes 10 to 75 miles from the medical center were included. Patient experience was assessed using the Consumer Assessment of Health Care Providers and Systems Clinician & Group Visit Survey 2.0 and the Communication Assessment Tool. Top box analysis was performed, defined as the percentage of respondents who chose the most positive response score.
The cohort consisted of 45 telemedicine and 32 in-person encounters. Both groups reported similar and excellent patient experience and satisfaction (9.7 of 10 for telemedicine vs 9.8 of 10 for in-person encounters, mean difference 0.02, 95% confidence interval, [-0.25 to 0.29]). Similar surgeon communication performance was observed (mean Communication Assessment Tool top box score 83% telemedicine vs 86% in-person, mean difference 3%, 95% confidence interval [-10% to 17%]). Nonlinear increases in monthly telemedicine encounter volume were observed within the section of endocrine surgery (3-fold increase) and the health system (125-fold increase) from November 2019 to May 2020.
Patients who underwent cervical endocrine surgery reported similarly high rates of satisfaction and excellent surgeon communication following either telemedicine or in-person postoperative encounters. Electronic health record-integrated telemedicine for a subset of low-risk procedures can act as a suitable replacement for in-person encounters. A surge in telemedicine use, stimulated by the coronavirus 2019 pandemic, was experienced at our institution.
为应对 2019 年冠状病毒病疫情，美国各地的远程医疗使用量有所增加。我们旨在衡量电子健康记录整合的甲状腺和甲状旁腺手术后远程医疗随访患者的体验。
在这项初步研究中，2019 年 11 月至 2020 年 5 月期间，在一家医疗机构接受电子健康记录整合远程医疗视频会诊或标准门诊随访的甲状腺或甲状旁腺手术后的成年患者被前瞻性纳入。患者的家庭邮编距离医疗中心在 10 至 75 英里范围内。患者体验通过医疗保健提供者和系统临床医生和小组就诊调查 2.0 和沟通评估工具进行评估。采用顶盒分析，定义为选择最积极反应评分的受访者百分比。
该队列包括 45 例远程医疗和 32 例门诊会诊。两组患者均报告了相似且极佳的患者体验和满意度（远程医疗为 9.7 分，门诊为 9.8 分，平均差值为 0.02，95%置信区间[-0.25 至 0.29]）。观察到相似的外科医生沟通表现（平均沟通评估工具顶盒评分远程医疗为 83%，门诊为 86%，平均差值 3%，95%置信区间[-10%至 17%]）。从 2019 年 11 月至 2020 年 5 月，内分泌手术（增加 3 倍）和整个医疗系统（增加 125 倍）的远程医疗每月会诊量呈非线性增加。
接受颈内分泌手术的患者在远程医疗或门诊术后随访后报告了相似的高满意度和极佳的外科医生沟通。对于某些低风险手术，电子健康记录整合的远程医疗可以作为门诊就诊的合适替代方案。我们机构经历了远程医疗使用量的激增，这是由 2019 年冠状病毒病疫情推动的。
