Telemedicine may provide the answer to costly consultations. According to data from a recent study, remote video visits demonstrated equivalent efficiency and satisfaction when compared with traditional office visits for men with surgically treated prostate cancer.
Rochester, MN-Telemedicine may provide the answer to costly consultations. According to data from a recent study, remote video visits demonstrated equivalent efficiency and satisfaction when compared with traditional office visits for men with surgically treated prostate cancer.
Dr. Viers“Video visits preserve efficiency and quality of care. They reduce patient costs, and they are a viable alternative to traditional health care delivery models,” said Boyd Viers, MD, a urologist at Mayo Clinic in Rochester, MN.
As Dr. Viers explained, recent studies have shown that disparities in access to health care lead to worse urologic outcomes. For patients in geographic areas with a lack of urologists, the implementation of telemedicine may provide a practical solution. However, limited data defining the role of telemedicine within urology exist.
“We currently have some data around telerounding, telemonitoring and telesurgery, and teleconsultation but nothing directly looking at the utility of remote telemedicine visits,” he said.
In a randomized, controlled trial powered to assess for equivalence in timing efficiency, Dr. Viers and colleagues enrolled 55 patients following radical prostatectomy. Video visits were given to patients at home and office visits followed the standard pathway. Invitation was offered to patients within 30 days of their pre-existing scheduled appointment. Patients living outside the states of Minnesota or Wisconsin and those who needed physical examination or failed to meet the technical requirements were excluded from the study.
The authors measured visit efficiency through direct observation. Satisfaction (of the patient and physician) and costs (for the patient) were assessed through a 21-point questionnaire, administered immediately following the visit.
“When we looked at our primary outcome-timing and efficiency-you can see that there are essentially no significant differences in timing parameters. The total time of the visit, as well as total face-time, patient-staff face-time, and patient wait-time were the same. When we assessed patient satisfaction, there was no significant difference in quality, efficiency, confidentiality of the visit, ability to share sensitive or personal information, or patient education overall,” reported Dr. Viers, who presented the findings at the AUA annual meeting in New Orleans. Findings were subsequently published in European Urology (2015; 68:729-35).
While there was no change in efficiency or patient satisfaction, costs were significantly reduced. With video visits, patients traveled significantly less time (mean, 26.9 vs. 148.2 minutes, p<.0001) and distance (mean, 10.1 vs. 130 miles, p<.0001) compared with office visits. Productivity was positively impacted, as well.
“In most cases, patients had to take a day off of work to come out to the clinic,” said Dr. Viers, “but they didn’t miss any work with the video visit.”
Dr. Viers estimated the cost of an office visit at $70. Video visits, on the other hand, cost approximately $1.
According to Dr. Viers, there was also a high level of provider satisfaction.
“Providers were very happy with the experience,” he said, “and our survey indicates that 96% of video-visiters would participate again.”
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Although Dr. Viers believes video visits are applicable to current care pathways, he acknowledges financial and regulatory barriers, as well as cultural resistance, to the implementation of telemedicine services.
“Our solutions would be to offer video visits greater than 30 days from any scheduled appointment to allow patients the appropriate accommodations and to provide patient education regarding potential equivalence between the video visits and traditional office visits. We also need to have more focused legislative efforts addressing these issues,” he concluded.
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