Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA.
Iowa Orthop J. 2021 Dec;41(2):40-44.
Recent events have resulted in rapid rises in the use of telemedicine in orthopaedic surgery, despite limited evidence regarding patient preferences or concerns. The purpose of this study is to determine access to and, ability to use telemedicine technology in an adult hip preservation patient population, as well as determine associations with patient characteristics. Additionally, we seek to understand patients' perceived benefits, risks and preferences of telemedicine.
We performed a cross-sectional survey administered on patients scheduled to undergo joint preservation surgery by one of three surgeons at a single academic institution. Both preoperative and postoperative established patients were included and called for a telephone administered survey if a date of surgery was scheduled between October 1, 2019 and March 30, 2020 and were 18 years or older. The survey had seven sections with 45 questions relating to demographics, technology access, videoconferencing capability, confidence using technology, telehealth experiences, perceptions.
101 patients completed the survey (48% response rate, 101/212). Overall, 99% of participants reported using the internet, 94% reporting owning a device capable of videoconferencing, and 86% of patients had participated in a video call in the past year. When asked for their preferred method for a physician visit: 79% ranked in-person as their first choice and 16% ranked a videoconference visit as their first choice. Perceived benefits of telemedicine visits included reduced travel to appointments (97% agree) and reduced cost of attending appointments (69% agree). However, patients were concerned that they would not establish the same patient-physician connection (51% agree) and would not receive the same level of care (38% agree) through telemedicine visits versus in person visits.
The majority of hip preservation patients have access to and are capable of using the technology required for telemedicine visits. However, patients still prefer to have in person visits over concerns that they will not establish the same patient-physician connection and will not receive the same level of care. Telemedicine visits in hip preservation patients may be most attractive to return patients with an established doctor-patient relationship, particularly those with concerns for long distances of travel and associated costs. III.
尽管有关患者偏好或关注点的证据有限，但最近的事件导致矫形外科领域迅速增加使用远程医疗。本研究的目的是确定成人髋关节保护患者人群中远程医疗技术的获取和使用能力，并确定与患者特征的关联。此外，我们还试图了解患者对远程医疗的感知益处、风险和偏好。
我们对在一家学术机构的三位外科医生之一接受关节保护手术的患者进行了横断面调查。包括术前和术后的既定患者，如果手术日期安排在 2019 年 10 月 1 日至 2020 年 3 月 30 日之间，并且年龄在 18 岁或以上，则会被呼叫进行电话管理调查。调查有七个部分，共 45 个问题，涉及人口统计学、技术获取、视频会议能力、使用技术的信心、远程医疗体验、感知。
101 名患者完成了调查（48%的回复率，101/212）。总体而言，99%的参与者报告使用互联网，94%报告拥有可进行视频会议的设备，86%的患者在过去一年中参加过视频通话。当被问及他们对医生就诊的首选方式时：79%的人将面对面就诊列为首选，16%的人将视频就诊列为首选。远程医疗就诊的好处包括减少就诊旅行（97%的人同意）和减少就诊费用（69%的人同意）。然而，患者担心他们不会与医生建立同样的医患联系（51%的人同意），并且通过远程医疗就诊不会获得与面对面就诊相同的护理水平（38%的人同意）。
大多数髋关节保护患者都可以访问和使用远程医疗就诊所需的技术。然而，患者仍然更愿意进行面对面就诊，因为他们担心不会与医生建立同样的医患联系，也不会获得与面对面就诊相同的护理水平。在髋关节保护患者中，远程医疗就诊可能对具有既定医患关系的复诊患者最具吸引力，特别是那些对长途旅行和相关费用有顾虑的患者。
