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Digital Online Anaesthesia Patient Informed Consent before Elective Diagnostic Procedures or Surgery: Recent Practice
Claudia Neumann1, Grigorij Schleifer1, Nadine Strassberger-Nerschbach1
1Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
Insights
Digital pre-operative informed consent is not standard practice in Europe, with most clinicians uncertain about legalities. Telemedicine may benefit high-risk pediatric patients by reducing hospital exposure.
Area of Science:
- Medical Informatics
- Health Policy
- Pediatric Anesthesia
Background:
- Digital support offers contact reduction, crucial during the COVID-19 pandemic.
- Limited data exists on Europe-wide digital pre-operative patient information or evaluation.
- This study provides an overview of the current status in Europe.
Purpose of the Study:
- To assess the current use of digital online pre-operative patient information and evaluation in Europe.
- To understand the practices and perceptions regarding informed consent in anesthesia across Europe.
- To explore the potential of telemedicine in pediatric anesthesia.
Main Methods:
- A web-based questionnaire was distributed to members of the European Society of Anaesthesia and Intensive Care Medicine (ESAIC).
- The survey covered the informed consent process, including specific questions for pediatric anesthesia.
- Responses were collected from 930 participants across 47 European countries.
Main Results:
- 70.2% found obtaining informed consent online not feasible in routine practice; 67.3% were unsure of legal compliance.
- In pediatric anesthesia, one parent's consent was often sufficient, but identity verification was inconsistently applied.
- While most preferred in-person consent, many were open to online/telephone alternatives if regulations allowed.
Conclusions:
- Online or telephone informed consent in pediatric anesthesia is not standard European practice and varies significantly.
- Telemedicine could benefit high-risk pediatric patients, like those with congenital heart defects, by minimizing contact and health risks.
- Future implementation requires addressing legal uncertainties and adapting regulations to facilitate digital consent processes.
Background:
One undisputed benefit of digital support is the possibility of contact reduction, which has become particularly important in the context of the COVID-19 pandemic. However, to the best of our knowledge, there is currently no study assessing the Europe-wide use of digital online pre-operative patient information or evaluation in the health sector. The aim of this study was to give an overview of the current status in Europe.
Methods:
A web-based questionnaire covering the informed consent process was sent to members of the European Society of Anaesthesia and Intensive Care Medicine (ESAIC) in 47 European countries (42,433 recipients/930 responses). Six questions related specifically to the practice in paediatrics.
Results:
A total of 70.2% of the respondents indicated that it was not possible to obtain informed consent via the Internet in a routine setting, and 67.3% expressed that they did not know whether it is in line with the legal regulations. In paediatric anaesthesia, the informed consent of only one parent was reported to be sufficient by 77.6% of the respondents for simple interventions and by 63.8% for complex interventions. Just over 50% of the respondents judged that proof of identity of the parents was necessary, but only 29.9% stated that they ask for it in clinical routine. In the current situation, 77.9% would favour informed consent in person, whereas 60.2% could imagine using online or telephone interviews as an alternative to a face-to-face meeting if regulations were changed. Only 18.7% participants reported a change in the regulations due to the current pandemic situation.
Conclusion:
Whether informed consent is obtained either online or on the telephone in the paediatric population varies widely across Europe and is not currently implemented as standard practice. For high-risk patients, such as the specific cohort of children with congenital heart defects, wider use of telemedicine might provide a benefit in the future in terms of reduced contact and reduced exposure to health risks through additional hospital stays.
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