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E-consensus on telemedicine in colorectal surgery: a RAND/UCLA-modified study.

Gaetano Gallo1, Arcangelo Picciariello2,3, Gian Luca Di Tanna4

  • 1Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy. gallog@unicz.it.

Updates in Surgery
|July 27, 2021
PubMed
Summary

Telemedicine is applicable for pre-operative evaluations and follow-ups in colorectal surgery, but not for initial consultations. Experts reached consensus on its use, defining boundaries for telemedicine in Italy.

Keywords:
COVID-19ColorectalRAND/UCLATeleconsultationTelehealthTelemedicine

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Area of Science:

  • Colorectal Surgery
  • Digital Health
  • Healthcare Innovation

Background:

  • The COVID-19 pandemic has accelerated the adoption of telemedicine in healthcare.
  • The integration of telemedicine into colorectal surgery requires expert consensus on its appropriate applications.

Purpose of the Study:

  • To establish expert consensus on the clinical practice recommendations for telemedicine in colorectal surgery within Italy.
  • To define the scope and limitations of telemedicine applications in this surgical specialty.

Main Methods:

  • A Delphi-like consensus method using RAND/UCLA criteria was employed.
  • 54 colorectal surgeons from the Italian Society of Colo-Rectal Surgery (SICCR) evaluated 48 clinical practice recommendations (CPRs) over two rounds.
  • Expert opinion was gathered and analyzed to determine agreement on telemedicine applications.

Main Results:

  • Strong agreement was reached on using telemonitoring and telemedicine for multidisciplinary pre-operative evaluations.
  • The panel reached consensus against using telemedicine for initial patient consultations.
  • Teleconsultation showed strong agreement for follow-up care in patients with diverticular disease post-in-person visit.
  • Consensus was achieved on most recommendations, with uncertainty primarily surrounding teleconsultation costs.

Conclusions:

  • Telemedicine offers defined applications in colorectal surgery, particularly for pre-operative assessments and post-operative follow-up.
  • Exclusion of telemedicine for first consultations and the need for infrastructure/cost standardization are key findings.
  • This e-consensus provides crucial guidance for implementing telemedicine in Italian colorectal surgery practices.