RESUMEN
Objective The purpose of this study was to evaluate pituitary tumor patient satisfaction with telemedicine, patient preference for telemedicine, potential socioeconomic benefit of telemedicine, and patients' willingness to proceed with surgery based on a telemedicine visit alone. Method In total, 134 patients who had pituitary surgery and a telemedicine visit during the coronavirus disease 2019 (COVID-19) pandemic (April 23, 2020-March 4, 2021) were called to participate in a 13-part questionnaire. Chi-square, ANOVA, and Wilcoxon Rank Sum tests were used to determine significance. Result Of 134 patients contacted, 90 responded (67%). Ninety-five percent were "satisfied" or "very satisfied" with their telemedicine visit, with 62% stating their visit was "the same" or "better" than previous in-person appointments. Eighty-two percent of the patients rated their telemedicine visit as "easy" or "very easy." On average, patients saved 150 minutes by using telemedicine compared with patient reported in-person visit times. Seventy-seven percent of patients reported the need to take off from work for in-person visits, compared with just 12% when using telemedicine. Forty-nine percent of patients preferred in-person visits, 34% preferred telemedicine, and 17% had no preference. Fifty percent of patients said they would feel comfortable proceeding with surgery based on a telemedicine visit alone. Patients with both initial evaluation and follow-up conducted via telemedicine were more likely to feel comfortable proceeding with surgery based on a telemedicine visit alone compared with patients who had only follow-up telemedicine visits ( p = 0.051). Conclusion Many patients are satisfied with telemedicine visits and feel comfortable proceeding with surgery based on a telemedicine visit alone. Telemedicine is an important adjunct to increase access to care at a Pituitary Center of Excellence.
RESUMEN
INTRODUCTION: COVID-19 has accelerated the use of telemedicine in all aspects of health care delivery, including initial surgical evaluation. No existing literature investigates the safety and efficacy of telemedicine to preoperatively evaluate spine surgery candidates. Our objectives were: (1) Compare the change in visual analogue scale (VAS) scores between the telemedicine preoperative visit and in-person preoperative visit groups. (2) Compare the average surgical time, estimated blood loss (EBL), length of hospital stay (LOS), rates of intraoperative complications, rates of readmission, and rates of reoperation between the telemedicine preoperative visit and in-person preoperative visit groups. METHODS: The previously stated metrics were collected for 276 patients, 138 who were exclusively evaluated preoperatively with telemedicine and 138 historical controls who were evaluated preoperatively in person. We used χ2 and independent samples t tests to determine significance. RESULTS: There were no significant differences in the mean change in VAS scores (-2.7 ± 3.1 telemedicine vs. -2.2 ± 3.7 in-person, P = 0.317), mean percentage change in VAS scores (-40.5% ± 54.3% vs. -39.5% ± 66.6%, P = 0.811), mean surgical time (2.4 ± 1.4 hours vs. 2.3 ± 1.3 ours, P = 0.527), mean EBL (150.4 ± 173.3 mL vs. 156.7 ± 255.0 mL, P = 0.811), mean LOS (3.3 ± 2.4 days vs. 3.3 ± 2.5 days, P = 0.954), intraoperative complication rates (0.7% vs. 1.4%, P = 0.558), reoperation rates (7.9% vs. 4.3%, P = 0.208), or readmission rates (10.1% vs. 5.1%, P = 0.091) between the telemedicine preoperative visit and in-person preoperative visit groups. CONCLUSIONS: Preoperative evaluation via telemedicine leads to the same short-term surgical outcomes as in-person evaluation with no increased risk of surgical complications.
