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Orthopaedic Oncologic Consultation Using Asynchronous Telemedicine: Expedited Triage and Reduced Clinic Visits
Jonathan D Kass1, Nicholas C Arpey, Devin J Conway
1From the College of Medicine, University of Florida (Kass); the Department of Orthopaedic Surgery, University of Florida, Gainesville, FL (Arpey, Conway, Gibbs, Scarborough, and Spiguel).
Introduction:
Asynchronous telemedicine has emerged as a promising tool for increasing access to care and triaging patients for evaluation in clinic. However, the role of asynchronous telemedicine in the delivery of orthopaedic oncologic care has yet to be determined. The purpose of this study was to evaluate response time for these electronic consults and characterize their triage outcomes.
Methods:
Two hundred sixty-eight patients whose clinical data were reviewed using asynchronous telemedicine by an orthopaedic oncologist at a tertiary academic medical center from May 2020 to August 2023 were retrospectively identified. Demographic and clinical information, response time to consult, and triage outcome were collected and reported with descriptive statistics. Response time to asynchronous consults was compared with wait time for patients referred directly for a synchronous telehealth appointment using the Mann-Whitney U test.
Results:
Most patients (71.6%) live more than 100 miles from the clinic. After initial asynchronous review, 131 patients (48.9%) were invited to schedule an in-person appointment, 42 (15.7%) of whom eventually underwent biopsy or surgery. Nonsurgical follow-up with repeat imaging in the future was recommended for 72 patients (26.9%). As-needed follow-up was suggested for 65 patients (24.2%). The average response time to asynchronous consult was 6.9 days (median 4.0, SD 7.9 days) compared with wait time of 17.0 days (median 13.0, SD 17.9 days) for synchronous telehealth visit (P < 0.01).
Conclusion:
Asynchronous telemedicine can expedite triage of orthopaedic oncology patients and reduce unnecessary in-person visits, which may be particularly beneficial for those seeking care from far distances. Additional studies are needed to assess clinical outcomes and patient satisfaction with this approach to care delivery.
