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A Randomized Controlled Trial Comparing pre-anesthesia Evaluation via Telemedicine to In-Person at an NCI-Designated
Nasrin N Aldawoodi1, Kea Turner2, Krupal Patel3
1Department of Anesthesiology and Critical Care, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Summary
Virtual pre-anesthesia evaluations using remote stethoscopes offer significant time, cost, and environmental benefits. This telemedicine approach demonstrated high patient satisfaction and comparable accuracy to in-person visits.
Area of Science:
- Anesthesiology
- Medical Informatics
- Health Services Research
Background:
- Pre-anesthesia evaluation (PAE) is crucial for surgical readiness.
- Traditional in-person PAE can be time-consuming and resource-intensive.
- Advancements in telemedicine offer potential for remote patient assessment.
Purpose of the Study:
- To compare the efficacy and patient experience of in-person PAE versus virtual PAE utilizing a remote digital stethoscope.
- To assess the concordance of remote examinations with in-person assessments.
Main Methods:
- A randomized study involving 106 patients undergoing hysterectomy or prostatectomy.
- Patients were assigned to either in-person PAE or telemedicine PAE with an Eko Duo™ stethoscope.
- Key metrics included remote auscultation success, airway exam concordance, visit duration, and patient-reported outcomes.
Main Results:
- The remote stethoscope successfully captured heart sounds and ECG in 39/49 patients.
- Airway exam concordance was high and similar between in-person (62%) and virtual (65%) groups.
- Telemedicine PAE resulted in significantly shorter visit times and substantial savings in travel distance, time, cost, and CO2 emissions.
Conclusions:
- Telemedicine PAE is a viable alternative to in-person evaluations, offering significant logistical and economic advantages.
- Virtual visits were associated with shorter scheduling times and did not increase day-of-surgery cancellations.
- High patient satisfaction and concordance of remote examinations support the integration of telemedicine with digital stethoscopes into routine PAE.
