Effectiveness of Telemedical Applications in Postoperative Follow-Up After Total Joint Arthroplasty

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Abstract

We hypothesized that a postoperative clinical telemedicine tool will be effective in reducing the total number of unscheduled postoperative clinic visits and calls while increasing patient satisfaction. The medical charts of 34 patients who underwent telemedicine follow-up during their postoperative care were compared to that of 44 patients who did undergo telemedicine follow-up. There were 14 unscheduled clinic visits in the non-telemedicine follow-up group compared to only 3 in the telemedicine follow-up group (P = 0.01). There were 40 in-clinic calls made by patients in the non-telemedicine follow-up group compared to only 6 made by patients in the telemedicine group (P < 0.01). In addition, patients who underwent telemedicine follow-up rated their postoperative satisfaction higher than those who did not undergo telemedicine follow-up.

Section snippets

Materials and Methods

The method of telemedicine used in the study was Skype (Skype Communications SARL, Luxembourg), the proprietary voice-over-Internet Protocol service. Skype has been reported in the past as an effective and simple way for a physician to communicate with a patient 13., 14.. A consecutive series of 78 patients who underwent total joint arthroplasty from November 2012 to March 2013 were asked to communicate with their surgeon postoperatively via Skype on 5 added encounters in addition to their

Length of Calls and Weekly Sessions

The average Skype call per patient was 2.71 minutes (± 0.93, range: 36 seconds to 9.88 minutes). The average number of Skype calls conducted by the physician per week was 4.68 (± 2.55, range: 1–11) while the average length of the weekly Skype session (all calls combined) was 12.15 minutes (± 5.33 minutes, range: 1.74–26.53 minutes). The average number of Skype calls per week varied depending on the number of total joint arthroplasties on a given week (Table 1).

Demographics, Unscheduled Clinic Visits and Clinic Calls

The average age of patients in the

Discussion

To date, we believe this is the only study to analyze the effects of telemedicine on reduction of in-clinic visits and calls in an orthopedic clinical setting. The use of Skype to undergo telemedicine orthopedic follow-up has been performed once previously by Good et al [14]. In that study, a functional assessment of patients with clavicle fractures following treatment with acromioclavicular joint hook plates was performed via Skype and compared to numbers obtained from in-clinic visits [14].

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The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.09.019.

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