LBA2 THE USE OF TELEMEDICINE FOR THE POSTOPERATIVE UROLOGIC CARE OF CHILDREN: RESULTS OF A PILOT PROGRAM

Abstract

You have accessJournal of UrologyPlenary: Next Frontier1 Apr 2018LBA2 THE USE OF TELEMEDICINE FOR THE POSTOPERATIVE UROLOGIC CARE OF CHILDREN: RESULTS OF A PILOT PROGRAM Julia B Finkelstein, Michael P Kurtz, Julie Campbell, Briony K Varda, Rosemary Grant, Caleb P Nelson, and Carlos R Estrada, Jr. Julia B FinkelsteinJulia B Finkelstein More articles by this author , Michael P KurtzMichael P Kurtz More articles by this author , Julie CampbellJulie Campbell More articles by this author , Briony K VardaBriony K Varda More articles by this author , Rosemary GrantRosemary Grant More articles by this author , Caleb P NelsonCaleb P Nelson More articles by this author , and Carlos R Estrada, Jr.Carlos R Estrada, Jr. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.03.081AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES For postoperative visits, which are often brief interactions between family and clinician, the costs may be out of proportion to the perceived benefits of the visit. Our objective was to evaluate the feasibility of telemedicine for postoperative encounters in pediatric urology. METHODS This is a prospective telemedicine pilot study during a 12-week implementation period from 11/10/17 to 2/6/18. All postoperative patients deemed eligible by one of two urologists were offered enrollment in the telemedicine program. Enrollees underwent at least one virtual visit within six weeks of surgery. After each virtual evaluation, the guardian and clinician were prompted to complete a survey pertaining to perceptions of the telemedicine experience, including their overall satisfaction (rated 1 to 10) and how effective the virtual visit was in delivering care. The following variables of interest were tracked: appointment compliance, estimated travel expense and time saved per round-trip visit, virtual waiting room and visit time as well as number of unscheduled clinic or emergency department (ED) visits, complications, and readmissions. Any technical difficulties were also noted. RESULTS During the study period, 64 postoperative virtual visits were performed in 45 patients. There was 97% technical success with utilization of the telemedicine software. Surgeries included labioplasty (1), circumcision (12) and circumcision revision (5), lysis of penile adhesions (2), hypospadias repair (2), hydrocele/hernia repair (5), scrotal orchidopexy (5), ureteral reimplant (6), stoma revision (4) and stone procedures (3). The median age of children was 4.0 years (IQR 1.1 to 9.0 years) and 73% of patients were boys. Families saved a mean of $378 of travel cost and 3.9 hours of travel time per visit. Inspection of the postoperative incision was possible in all appropriate cases. Clinicians found that the virtual visit was “very effective” in 86% of cases, delivering the same care that they would have provided during an in-person visit. Mean guardian and provider satisfaction with the virtual visit experience overall was 9.9 and 9.0, respectively. No adverse postoperative outcomes were observed. There were no unscheduled clinic or ED visits. CONCLUSIONS This pilot study demonstrates that telemedicine can be successfully implemented in the postoperative care of pediatric urology patients. Use of this innovative technology was feasible and reduced unnecessary costs to the family, while maintaining high satisfaction for clinicians, patients and their families. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e577 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Julia B Finkelstein More articles by this author Michael P Kurtz More articles by this author Julie Campbell More articles by this author Briony K Varda More articles by this author Rosemary Grant More articles by this author Caleb P Nelson More articles by this author Carlos R Estrada, Jr. More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...