P58. Telemedicine visits generate accurate interventional procedure plans in spine patients without in person evaluations

Abstract

<h3>BACKGROUND CONTEXT</h3> The role of telemedicine in the evaluation and treatment of patients with spinal disorders is rapidly expanding. Health systems are working to understand the potential of this modality and optimally leverage telemedicine for spine service line care delivery. Specifically, the ability of pain management specialists (eg, physiatry and anesthesia) to accurately diagnose and plan appropriate interventional spine procedures based on virtual visits remains to be established. <h3>PURPOSE</h3> To assess whether spine procedure plans established solely from virtual visits changed following in person evaluation. <h3>STUDY DESIGN/SETTING</h3> Retrospective cohort study. <h3>PATIENT SAMPLE</h3> We evaluated the records of new patients who were seen virtually between March-June 2020, who were indicated for interventional spine procedures with documented procedure plans, and who subsequently underwent in-person evaluation prior to the procedure. <h3>OUTCOME MEASURES</h3> The primary outcome of interest was agreement between procedure plans generated by new virtual visit encounters and subsequent in-person evaluations. Secondarily, we characterized virtual physical exam variability across interventional spine specialists. <h3>METHODS</h3> We reviewed virtual and in-person clinical encounters from our academic health system's 10 interventional spine specialists (anesthesiology and physiatry). We included patients who were seen exclusively via telemedicine encounters and indicated for an interventional procedure with documented procedural plans. Virtual plans were compared to procedures performed following in person evaluation. Demographic data, patient primary complaint, and the extent of physical examination performed by the interventional spine specialist were also recorded. <h3>RESULTS</h3> Of the 87 patients included, the pre-procedural plan established by telemedicine did not change for 76 individuals (87%; 95% CI 0.79, 0.94) following in-person evaluation. There was wide variability in the use and extent of virtual physical exams performed by interventional providers. <h3>CONCLUSIONS</h3> Our findings indicate that telemedicine evaluations are an accurate means of pre-procedural assessment and demonstrate the capabilities of telemedicine in the evaluation of spine patients and the planning of interventional spine procedures. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.