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Prospective randomized controlled trial using telemedicine for follow-ups in an orthopedic trauma population: a pilot
Vasanth Sathiyakumar1, Jordan C Apfeld, William T Obremskey
1The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Nashville, TN.
Objectives:
To compare patient satisfaction between telemedicine and in-person follow-up appointments for orthopedic trauma.
Design:
Prospective randomized controlled trial (pilot study).
Setting:
Level I trauma center.
Patients/Participants:
Twenty-four patients were enrolled and randomized into 2 groups. Eight patients who had telemedicine follow-up appointments and 9 who had in-person follow-up visits were included in a per-protocol analysis. In the telemedicine group, 2 patients left the study because of nonadherence, 1 patient withdrew because of a weak Internet connection, and 1 patient sustained an open fracture. Three control patients left the study because of nonadherence.
Intervention:
The patients had 4 follow-up appointments during a 6-month period. Patients either had their 6-week and 6-month follow-ups through video calls or in the clinic.
Main Outcome Measurements:
After 6-week and 6-month follow-up appointments, the patients were given survey questions that were developed using literature-supported methods to compare follow-up experiences. The patients were monitored for complications.
Results:
There was no significant difference in patient satisfaction between telemedicine and in-person clinic visits (telemedicine: 89% satisfied; control: 100% satisfied; P = 0.74). Zero percent of patients in the telemedicine group took time off their work for their appointment compared with 55.6% in the control (P = 0.03). Telemedicine patients spent significantly less time on their visits (P = 0.01). The majority of the patients in the telemedicine group reported clear visual (87.5%) and sound quality (100%) through and agreed to future follow-up visits through telemedicine (75.0%). One patient in each group developed complications.
Conclusions:
Telemedicine may be a viable alternative to some in-person clinic visits because of similar measures of patient satisfaction but with significantly less time and distance traveled.
Level Of Evidence:
Therapeutic level II. See Instructions for authors for a complete description of levels of evidence.