Teleconsultation for pre-operative evaluation during the coronavirus disease 2019 pandemic: A technical and medical feasibility study.

Abstract

BACKGROUND\nDuring the surge in coronavirus disease 2019 (COVID-19) infections in early 2020, many medical organisations began developing strategies for implementing teleconsultation to maintain medical services during lockdown and to limit physical contact. Therefore, we developed a teleconsultation for preoperative evaluation platform to replace on-site preoperative meetings.\n\n\nOBJECTIVE\nThis study assessed the feasibility of a teleconsultation for pre-operative evaluation and procedure-associated adverse events.\n\n\nDESIGN\nImplementation study.\n\n\nSETTING\nA tertiary care university hospital in Germany from April 2020 to October 2020.\n\n\nPATIENTS\nOne hundred and eleven patients scheduled for elective surgery.\n\n\nINTERVENTION\nPatients were assigned to receive teleconsultation for preoperative evaluation and to complete a subsequent survey.\n\n\nMAIN OUTCOME MEASURES\nPrimary endpoints were medical and technical feasibility, user satisfaction and time savings.\n\n\nRESULTS\nFor 100 out of 111 patients, telepre-operative consultations allowed for adequate peri-operative risk assessment and patient education and also for effective collection of legal signatures. For six patients (5.4%), consultations could not be started because of technical issues, whereas for five patients (4.8%), clearance for surgery could not be granted because of medical reasons. A clear majority of anaesthetists (93.7%) rated the telepre-operative evaluations as equivalent to on-site meetings. The majority of the patients considered teleconsultation for preoperative evaluation as convenient as an on-site meeting (98.2%) and would choose a teleconsultation again (97.9%). Median travel time saved by patients was 60\u200amin (Q1 40, Q3 80). We registered one adverse event: we detected atrial fibrillation in one patient only immediately prior to surgery.\n\n\nCONCLUSION\nTelepre-operative evaluations are medically and technically feasible, yielding high satisfaction rates on both sides. However, regarding patient safety, not every patient is equally well suited. Overall, implementation of teleconsultation for preoperative evaluation into clinical routine could help maintain medical care during the COVID-19 pandemic.\n\n\nTRIAL REGISTRATION\nNCT04518514, ClinicalTrials.gov.