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Study shows tele-health effective for postoperative care of select patients

talking_phone_071013Past studies have shown that virtual medical visits, those conducted via telephone or Internet, are a cost-effective way to, among things, monitor low-risk newborns after they leave the hospital, decrease health disparities between rural and urban areas, deliver care to Parkinson’s patients, and reduce pediatric visits to the emergency department.

Now findings published in JAMA Surgery show that tele-health can be safely used as a substitute for standard postoperative visits for select ambulatory patients. The study was conducted by Sherry Wren, MD, a general surgeon at Stanford, and Kimberly Hwa, MMS, PA-C, a general surgeon with the Palo Alto Veterans Administration Health Care System.

The 10-month study involved a group of patients who underwent open herniorrhaphy or laparoscopic cholecystectomy and opted to enroll in a tele-health follow-up program instead of returning to the clinic for a postoperative visit. A physician assistant called participants two weeks after surgery and assessed their condition using a scripted evaluation. Overall, complications in the tele-health program were zero for cholecystectomy patients and 4.8 percent for individuals recovering from herniorrhaphy.

Beyond showing that tele-health can be safely and effectively used for the postoperative care of low-risk surgical patients, the findings identified additional benefits for patients and clinics. As Wren told me in a phone interview:

The tele-health program is very patient centered, and patients expressed great satisfaction with the telephone follow-up method. Patients' time and travel expenses were significantly reduced because they could schedule the calls at their convenience and didn't have to go anywhere. If patients had visited the clinic, the average round-trip distance traveled would have been about 140 miles and the average driving time, which we measured using Google Maps, would have been about 148 minutes.

Another benefit to the tele-health program was that the clinic was able to open up 110 spots, which could be used for new patients, and reduce patient wait times. This was all accomplished using a very low-tech method: telephone calls. Often tele-health approaches require patients to go to a clinic where there is provider and use a videoconferencing system to be evaluated virtually by another provider. In comparison, our approach is much simpler and easier to implement, yet still safe and effective.

Wren and Hwa have expanded the program at the Palo Alto VA to include patients undergoing appendectomies and laparoscopic inguinal hernia.

Previously: Can Internet monitoring of healthy newborns replace conventional post-discharge practices?, Examining the clinical benefits of “virtual” house calls for Parkinson’s patients, FCC allocates $400 million in funding to develop and expand telemedicine and Telemedicine takes root in the Midwest
Photo by Kelvin_Kevin Gan

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