Original ArticleTelehealth Adoption Across Neurosurgical Subspecialties at a Single Academic Institution During the COVID-19 Pandemic
Introduction
Telemedicine, or the remote diagnosis and treatment of patients by means of telecommunications technology, has been used in clinical practice for decades,1 with orthopedic surgeons reporting using traditional telephones to remotely examine patients in 1999.1,2 Although sometimes used interchangeably with telemedicine, telehealth is a broader term that describes the delivery of health care, health education, and health information services via remote technologies such as mobile health, video and audio technologies, and remote patient monitoring.1
The COVID-19 pandemic has led to rapid adoption and implementation of telehealth.3 At our institution, telehealth visits were implemented over 2 weeks in March 2020, a project that was initially intended to occur over several years. In this study, we present our experience with neurosurgery telehealth visits at a single academic institution before and during the COVID-19 pandemic. To the best of our knowledge, this is the first paper to assess telehealth utilization at different points during the pandemic and by different neurosurgical subspecialties, while also secondarily evaluating patient and physician satisfaction with telehealth visits during this time.
Section snippets
Methods
We retrospectively analyzed adoption of telehealth at our institution as a whole and in the following specialties during the COVID-19 pandemic (March 2020 to December 2020): cardiology, dermatology, endocrinology, ENT-otolaryngology, primary care, internal medicine, neurology, neurosurgery, ophthalmology, orthopaedics, psychiatry and urology (Figure 1).
Next, we retrospectively reviewed all neurosurgery visits performed from January 1, 2019, through November 2, 2020, at the outpatient clinic of
Results
During the COVID-19 pandemic, our institution used phone or video for an average (±SD) 24.1% (±9.8%) of all patient visits. The neurosurgery department observed a higher adoption of telehealth visits, 37.9% (±10.7%) (Figure 1).
Over the study period, our neurosurgery outpatient clinic had a mean (±SD) of 284 ± 69 visits per week, of which 36% were spine, 33% tumor, 10% pain, 8% vascular, 5% functional, 5% peripheral nerve, and 2% trauma (Supplemental Figure 1).
Between phase 0 (control/baseline,
Discussion
Development and use of telehealth technologies have increased worldwide over the last decade. Prior to the COVID pandemic, the market value of telehealth in the United States was expected to reach $36.2 billion by 2022.4 In 2013, 22 million telehealth visits were performed in the United States, increasing to 30 million in 2017, with an anticipated 46–81 million telehealth visits by 2022.5 In June 2018, over 50% of U.S. hospitals had telehealth programs, and 90% of executives stated their
CONCLUSIONS
Patients and providers uniformly reported positive experiences with video visits at our institution. There are differences in telehealth utilization across neurosurgical subspecialties, with certain specialties (pain, tumor, trauma) being more amenable to video visits than others (e.g., peripheral nerve or functional neurosurgery). Patient LTR did not change with the implementation of video visits. Given these findings, we believe that telehealth will be a valuable tool for neurosurgeons to
CRediT authorship contribution statement
Christopher Leung: Methodology, Formal analysis, Investigation, Writing - original draft, Visualization. Harsh Wadhwa: Formal analysis, Writing - review & editing. Matthew Sklar: Methodology, Validation. Kunj Sheth: Conceptualization. Sophia Loo: Methodology. John Ratliff: Writing - review & editing. Corinna C. Zygourakis: Conceptualization, Writing - review & editing, Supervision.
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Cited by (0)
Conflict of interest statement: C.C. Zygourakis is a consultant for Stryker, 7D, Globus, and SpineAlign.