Telemedicine for pediatric surgical outpatient follow-up: A prospective, randomized single-center trial.

Abstract

BACKGROUND AND PURPOSE\nTelemedicine is gaining popularity for a variety of indications. We performed a randomized controlled trial comparing telemedical versus conventional clinic follow-up in terms of feasibility and quality.\n\n\nMETHODS\nPatients discharged from pediatric surgery were randomized to telemedical or onsite follow-up. In the telemedical group, video telephony was used to obtain interim history and physical findings. Onsite patients were personally seen in the outpatient clinic. Caregivers completed a postvisit survey on satisfaction and efficiency. Providers scored data transmission quality and clinical interpretability.\n\n\nRESULTS\nFrom March 2015 until January 2017, 224 patients were randomized equally to the study groups. Telemedicine was highly accepted by caregivers, and data transmission quality was sufficient for comprehensive follow-up. No important clinical findings were missed. Quality of interaction scored higher in the telemedical versus the onsite group (77.8% vs. 48%, p\u202f<\u202f0.001) as did caregiver satisfaction (5.4 vs. 5.1, p\u202f<\u202f0.03). Travel investment, time required, loss of earnings, and days off from work/school were all significantly lower in the telemedical group (p\u202f<\u202f0.001).\n\n\nCONCLUSIONS\nTelemedical posthospitalization follow-up in pediatric surgery provides a cost-effective, time-saving alternative for patients and caregivers that is well received and accepted. The quality of clinical data transmission is sufficient to provide safe care and uncompromised clinical judgment.\n\n\nTYPE OF STUDY\nProspective and randomized controlled study.\n\n\nLEVEL OF EVIDENCE\nLevel 1b.