Neurosurgery Resident Physician University of Arkansas for Medical Sciences Little Rock, Arkansas, United States
Disclosure(s):
Zachary Porter, MD: No financial relationships to disclose
Introduction: The Coronavirus pandemic has drastically altered conventional healthcare access. Practitioners have become increasingly reliant on telecommunication to exchange information with patients. Conventionally, imaging studies paired with findings from the preoperative history and physical examination are utilized to establish the correct diagnosis. However, little is known regarding the validity of physical examination findings obtained by virtual appointments. The aim of this study is to evaluate and consolidate telehealth practices learned by expert Spine Surgeons during the Coronavirus Pandemic.
Methods: A survey of containing 38 data points were distributed to Fellows of the American Association of Neurological Surgeons with a specialty in Spine Surgery. 1018 surveys were distributed between December 1st 2021 and March 1st 2022. 45 surveys were completed. Exert consensus was defined as ≥ 80% agreement on a 3-point Likert scale (agree, disagree, no difference). Statistical analysis compared responses between infrequent users of telemedicine to those who utilize telemedicine in ≥ 25% of appointments.
Results: 12 consensus-driven best practices were identified, which include: telemedicine examinations differ from in-person examinations; telemedicine examinations can confidently assess cervical spine range of motion; telemedicine examinations cannot confidently assess distal upper extremity motor strength, sensory changes, or hyporeflexia or hyperreflexia in any extremity; and telemedicine is more cost-effective than in-person examinations. Frequent users of telemedicine found telemedicine to be more cost effective than in-person exams, associated with more patient satisfaction, and able to adequately assess motor strength and thoracolumbar spine pathology.
Conclusion : Surgeons are still learning the optimal way to incorporate telemedicine into clinical practice. However, lessons learned from the Coronavirus Pandemic may assist in optimizing patient care. This study suggests that telecommunication may be a learned skill, and with practice may be useful in maximizing patient outcomes by providing a remote and cost-effective means of exchanging healthcare information.
