Do teleconsultations increase patient access to orthopaedic care?

Area of Science:

• Orthopaedic Surgery
• Health Services Research
• Digital Health

Background:

• Access to timely orthopaedic care is crucial for patient outcomes.
• Teleconsultations are increasingly utilized but their efficiency compared to in-person visits requires evaluation.

Purpose of the Study:

• To compare the timeliness of access for orthopaedic teleconsultations versus in-person visits.
• To assess if teleconsultations offer superior scheduling efficiency and reduced patient delays.

Main Methods:

• Prospective analysis of scheduling data from July 2022 to January 2023 for 15 busy orthopaedic surgeons.
• Evaluation of third next available clinic day, same-day availability, and lead time, with standardization for visit modality frequency.
• Utilized Electronic Health Record (EHR) data to minimize cancellation bias and accurately capture access metrics.

Main Results:

• Teleconsultations demonstrated higher same-day availability (31.15% vs. 16.2%) and shorter lead times (median 5.0 days vs. 13.0 days) for new patients.
• When standardized for frequency, teleconsultations showed significantly better access efficiency (3.53 vs. 46.88).
• Despite lower volume (8% of total appointments), teleconsultations facilitated quicker scheduling for new patients.

Conclusions:

• Standardized analysis indicates teleconsultations provide superior access efficiency and timeliness compared to in-person orthopaedic visits.
• Increasing teleconsultation availability can enhance patient access, though in-person visits remain essential for acute conditions.
• Optimizing digital infrastructure, training, and workflows is vital for effective implementation of virtual care modalities.