Telemedicine in orthopaedic surgery during the COVID-19 pandemic patient attitudes and barriers

• Published in: Bone & joint open Vol. 2; no. 9; pp. 745 - 751
• Main Authors: Yakkanti, Ramakanth R., Sedani, Anil B., Baker, Lauren C., Owens, Patrick W., Dodds, Seth D., Aiyer, Amiethab A.
• Format: Journal Article
• Language: English
• Published: London The British Editorial Society of Bone & Joint Surgery 01.09.2021
• Subjects: anovas; chi-squared test; Complications; coronavirus; covid-19; covid-19 pandemic; foot and ankle; General Orthopaedics; Glucose; Glucose Variability; Glycated Haemoglobin; Glycemic Control; hand; hand surgeons; orthopaedic surgeons; orthopaedic surgery; patient barriers; t-test; telemedicine; variances
• ISSN: 2633-1462; 2633-1462
• DOI: 10.1302/2633-1462.29.BJO-2021-0083.R1

Aims This study assesses patient barriers to successful telemedicine care in orthopaedic practices in a large academic practice in the COVID-19 era. Methods In all, 381 patients scheduled for telemedicine visits with three orthopaedic surgeons in a large academic practice from 1 April 2020 to 12 June 2020 were asked to participate in a telephone survey using a standardized Institutional Review Board-approved script. An unsuccessful telemedicine visit was defined as patient-reported difficulty of use or reported dissatisfaction with teleconferencing. Patient barriers were defined as explicitly reported barriers of unsatisfactory visit using a process-based satisfaction metric. Statistical analyses were conducted using analysis of variances (ANOVAs), ranked ANOVAs, post-hoc pairwise testing, and chi-squared independent analysis with 95% confidence interval. Results The survey response rate was 39.9% (n = 152). The mean age of patients was 51.1 years (17 to 85), and 55 patients (38%) were male. Of 146 respondents with completion of survey, 27 (18.5%) reported a barrier to completing their telemedicine visit. The majority of patients were satisfied with using telemedicine for their orthopaedic appointment (88.8%), and found the experience to be easy (86.6%). Patient-reported barriers included lack of proper equipment/internet connection (n = 13; 8.6%), scheduling difficulty (n = 2; 1.3%), difficulty following directions (n = 10; 6.6%), and patient-reported discomfort (n = 2; 1.3%). Barriers based on patient characteristics were age > 61 years, non-English primary language, inexperience with video conferencing, and unwillingness to try telemedicine prior to COVID-19. Conclusion The barriers identified in this study could be used to screen patients who would potentially have an unsuccessful telemedicine visit, allowing practices to provide assistance to patients to reduce the risk of an unsuccessful visit. Cite this article: Bone Jt Open 2021;2(9):745–751.