Telehealth Follow-Up in Lieu of Postoperative Clinic Visit for Ambulatory Surgery: Results of a Pilot Program
What are outcomes related to an allied health professional telephone visit, compared to an in-person clinic visit, following select ambulatory surgical procedures?
This was a prospective case series conducted among 141 patients who underwent elective hernia repair or laparoscopic cholecystectomy during a 10-month study period at a University-affiliated Veterans Administration Health Care System. Patients were called 2 weeks following surgery by a trained certified physician assistant, and assessed using a scripted template. If the assessment suggested a satisfactory recovery and the patient was satisfied with the telehealth encounter as his/her postoperative assessment, his/her scheduled in-person postoperative visit was cancelled. Patients who preferred a clinic visit were seen; if the assessment suggested an abnormal recovery, the patient was scheduled for his/her scheduled appointment or sooner, if indicated. Main outcome measures were the percentage of patients who accepted telehealth follow-up, and 30-day postoperative complications.
Seventy-eight percent (110) of all patients were successfully contacted; 63 of 89 hernia patients (70.8%) and 19 of 21 laparoscopic cholecystectomy patients (90.5%) elected for telehealth follow-up. Of the cholecystectomy patients who accepted telehealth, none experienced a complication. Three patients (4.8%) following elective hernia repair experienced a complication; none of these were directly linked to lack of a postoperative visit. The average round-trip distance traveled to the hospital by those who accepted telehealth (n = 81) was 140.8 miles.
Following elective hernia repair or laparoscopic cholecystectomy, more than 70% of patients accepted a scripted telehealth visit conducted by a trained physician assistant in place of a standard in-person postoperative visit.
This pilot project demonstrates that a telephone call performed by a trained allied health care provider can safely be used in place of a standard in-person postoperative clinic visit. Such findings have broad implications and such programs should be explored further. Although a formal cost analysis was not performed in this study, time and expense for travel were reduced in this study. Freed clinic time allows for scheduling of new patients, improving access to care. The benefit of telehealth in lieu of in-person visits for appropriately selected patients cannot be underestimated.
Keywords: Outcome Assessment (Health Care), Postoperative Complications, Cholecystectomy, Laparoscopic, Follow-Up Studies, Hernia, Inguinal, United States Department of Veterans Affairs, Herniorrhaphy, United States
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