Telemedicine in the Evaluation and Management of Neurosurgical Spine Patients

Spine 2021;46:472–477

Study Design. Retrospective questionnaire study of all patients seen via telemedicine during the COVID-19 pandemic at a large academic institution.

Objective. This aim of this study was to compare patient satisfaction of telemedicine clinic to in-person visits; to evaluate the preference for telemedicine to in-person visits; to assess patients’ willingness to proceed with major surgery and/or a minor procedure based on a telemedicine visit alone.

Summary of Background Data. One study showed promising utility of mobile health applications for spine patients. No studies have investigated telemedicine in the evaluation and management of spine patients.

Methods. An 11-part questionnaire was developed to assess the attitudes toward telemedicine for all patients seen within a 7- week period during the COVID-19 crisis. Patients were called by phone to participate in the survey. x2 and the Wilcoxon Rank-Sum Test were performed to determine significance.

Results. Ninety-five percent were ‘‘satisfied’’ or ‘‘very satisfied’’ with their telemedicine visit, with 62% stating it was ‘‘the same’’ or ‘‘better’’ than previous in-person appointments. Patients saved a median of 105 minutes by using telemedicine compared to inperson visits. Fifty-two percent of patients have to take off work for in-person visits, compared to 7% for telemedicine. Thirtyseven percent preferred telemedicine to in-person visits. Patients who preferred telemedicine had significantly longer patient reported in-person visit times (score mean of 171) compared to patients who preferred in-person visits (score mean of 137, P=0.0007). Thirty-seven percent of patients would proceed with surgery and 73% would proceed with a minor procedure based on a telemedicine visit alone.

Conclusion. Telemedicine can increase access to specialty care for patients with prolonged travel time to in-person visits and decrease the socioeconomic burden for both patients and hospital systems. The high satisfaction with telemedicine and willingness to proceed with surgery suggest that remote visits may be useful for both routine management and initial surgical evaluation for spine surgery candidates.

Level of Evidence: 3

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