Telemedicine in Neurosurgery: Lessons Learned and Transformation of Care During the COVID-19 Pandemic.
COVID-19
Neurosurgery
Telemedicine
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
17
05
2020
revised:
26
05
2020
accepted:
28
05
2020
pubmed:
9
6
2020
medline:
28
8
2020
entrez:
9
6
2020
Statut:
ppublish
Résumé
Before the COVID-19 pandemic, telemedicine utilization was mostly used for postoperative visits only in neurosurgery. Shelter-in-place measures led the rapid expansion of telemedicine to address the needs of the neurosurgical patient population. Our goal is to determine the extent of adoption of telemedicine across tumor, vascular, spine, and function neurosurgery and utilization for new patient visits. A single-center retrospective cohort study of patients who received neurosurgical care at a tertiary academic center from February to April 2020 was conducted. Patients evaluated from March to April 2019 were included for comparison. A total of 10,746 patients were included: 1247 patients underwent surgery, 8742 were seen in clinic via an in-person outpatient visit, and 757 were assessed via telemedicine during the study period. A 40-fold increase in the use of telemedicine was noted after the shelter-in-place measures were initiated with a significant increase in the mean number of patients evaluated via telemedicine per week across all divisions of neurosurgery (4.5 ± 0.9 to 180.4 ± 13.9, P < 0.001). The majority of telemedicine appointments were established patient visits (61.2%), but the proportion of new patient visits also significantly increased to an average of 8.2 ± 5.3 per week across all divisions. Use of telemedicine drastically increased across all 4 divisions within neurosurgery with a significant increase in online-first encounters in order to meet the needs of our patients once the shelter-in-place measures were implemented. We provide a detailed account of the lessons learned and discuss the anticipated role of telemedicine in surgical practices once the shelter-in-place measures are lifted.
Sections du résumé
BACKGROUND
Before the COVID-19 pandemic, telemedicine utilization was mostly used for postoperative visits only in neurosurgery. Shelter-in-place measures led the rapid expansion of telemedicine to address the needs of the neurosurgical patient population. Our goal is to determine the extent of adoption of telemedicine across tumor, vascular, spine, and function neurosurgery and utilization for new patient visits.
METHODS
A single-center retrospective cohort study of patients who received neurosurgical care at a tertiary academic center from February to April 2020 was conducted. Patients evaluated from March to April 2019 were included for comparison. A total of 10,746 patients were included: 1247 patients underwent surgery, 8742 were seen in clinic via an in-person outpatient visit, and 757 were assessed via telemedicine during the study period.
RESULTS
A 40-fold increase in the use of telemedicine was noted after the shelter-in-place measures were initiated with a significant increase in the mean number of patients evaluated via telemedicine per week across all divisions of neurosurgery (4.5 ± 0.9 to 180.4 ± 13.9, P < 0.001). The majority of telemedicine appointments were established patient visits (61.2%), but the proportion of new patient visits also significantly increased to an average of 8.2 ± 5.3 per week across all divisions.
CONCLUSIONS
Use of telemedicine drastically increased across all 4 divisions within neurosurgery with a significant increase in online-first encounters in order to meet the needs of our patients once the shelter-in-place measures were implemented. We provide a detailed account of the lessons learned and discuss the anticipated role of telemedicine in surgical practices once the shelter-in-place measures are lifted.
Identifiants
pubmed: 32512241
pii: S1878-8750(20)31224-9
doi: 10.1016/j.wneu.2020.05.251
pmc: PMC7274123
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e387-e394Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Références
JAMA Intern Med. 2019 Nov 1;179(11):1580-1582
pubmed: 31355849
J Neurooncol. 2018 May;137(3):523-532
pubmed: 29322428
J Neurosurg. 2019 Sep 13;:1-6
pubmed: 31518981
Neurology. 2020 Jun 16;94(24):1077-1087
pubmed: 32358217
Musculoskelet Sci Pract. 2018 Dec;38:99-105
pubmed: 30366292
Clin Neurol Neurosurg. 2014 Oct;125:143-7
pubmed: 25128655
Telemed J E Health. 2015 Aug;21(8):686-93
pubmed: 25839672
Eur Spine J. 2018 Nov;27(11):2862-2874
pubmed: 30324496
Ann Transl Med. 2019 Sep;7(Suppl 5):S163
pubmed: 31624729
Neurosurgery. 2013 Oct;73(4):667-71; discussion 671-2
pubmed: 23842556
J Telemed Telecare. 2018 Jan;24(1):4-12
pubmed: 29320966