MP19-12 THE TELEMED VASECTOMY CONSULT IS A SAFE ALTERNATIVE TO IN PERSON CONSULTS: A RETROSPECTIVE STUDY IN A HIGH VOLUME CENTER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP19-12 THE TELEMED VASECTOMY CONSULT IS A SAFE ALTERNATIVE TO IN PERSON CONSULTS: A RETROSPECTIVE STUDY IN A HIGH VOLUME CENTER Phillip Westbrook and Richard Schoor Phillip WestbrookPhillip Westbrook More articles by this author and Richard SchoorRichard Schoor More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003244.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In March of 2020, telemedicine health care delivery catapulted from rare to ubiquitous in utilization and since then has been shown to be a safe method of health care delivery for a variety of illnesses. Some debate remains as to whether or not virtual consults can safely be done for pre-operative patients. In January 2021, our office, for reasons of scheduling efficiency, decided to offer men the option of scheduling elective sterilization consults as a telemedicine/virtual-visit, at the men’s own discretion. The present study investigated whether outcomes for elective sterilization were the same or different in men that chose telemedicine consults versus the more traditional in-person consult option. METHODS: Using a CPT code search feature on our electronic health record, completed vasectomy procedures between 12/1/2021 and 8/30/2022 were identified and flagged for chart review. Manual chart review was then undertaken to see if the consult was done in-person (IP) or as a telemedicine (TM) only consult. We then ascertained if the procedure was not attempted (NA), attempted and aborted (AA), or completed (C), and whether or not there were adverse events (AE) following the vasectomies, as defined using the Clavien-Dindo classification system. RESULTS: A total of 253 vasectomy procedures were done by one surgeon during the study period. 113 (45%) had IP consults prior to the vasectomy and 140 (55%) had TM consults prior to the vasectomy. All 253 were completed and none were either NA or AA from either the IP or TM groups. All 253 procedures were done under local anesthetic only. There were no adverse events that reached even a class 1 on the Clavien-Dindo scale from either group. A deeper dive into the data revealed that all vasectomies performed in December 2021 were IP and 15 of the vasectomies done in January were scheduled prior to the policy change. As such, after the policy change was fully implemented, men were ∼2.5 times more likely to opt for TM consults over IP ones (140 TM vs 56 IP). On a side note, 7% of men in the TM group called the office in the immediate post-op period to report a concern, compared to 16% in the IP consult group. One can only speculate on the reasons for this discrepancy. CONCLUSIONS: Telemedicine consults are a safe alternative to in-person consults for men who desire elective sterilization. In the hands of a skilled vasectomist, an IP consult can safely be bypassed. Men that elect to choose the TM consult can expect that they will be able to have their vasectomies completed on the day of the scheduled procedure and will have the same outcomes as men that elect to have in-person consults. The data suggest that Long Island men overwhelmingly prefer TM consults. Offices that are contemplating adopting a TM vasectomy consult policy can do so with confidence. Source of Funding: No funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e270 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Phillip Westbrook More articles by this author Richard Schoor More articles by this author Expand All Advertisement PDF downloadLoading ...