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Telemedicine for Pediatric Urological Postoperative Care is Safe, Convenient and Economical

2020; Lippincott Williams & Wilkins; Volume: 204; Issue: 1 Linguagem: Inglês

10.1097/ju.0000000000000750

1527-3792

Julia B. Finkelstein, Dylan Cahill, Katherine Young, Kate Humphrey, Julie M. Campbell, Caitlin Schumann, Caleb P. Nelson, Amar Gupta, Carlos R. Estrada,

Family and Patient Care in Intensive Care Units

No AccessJournal of UrologyPediatric Urology1 Jul 2020Telemedicine for Pediatric Urological Postoperative Care is Safe, Convenient and Economical Julia B. Finkelstein, Dylan Cahill, Katherine Young, Kate Humphrey, Julie Campbell, Caitlin Schumann, Caleb P. Nelson, Amar Gupta, and Carlos R. Estrada Julia B. FinkelsteinJulia B. Finkelstein *Correspondence: Boston Children's Hospital, Department of Urology, 300 Longwood Ave., Hunnewell 3, Boston, Massachusetts 02115 telephone: 617-355-4490; FAX: 617-730-0474; E-mail Address: [email protected] Boston Children's Hospital, Boston, Massachusetts , Dylan CahillDylan Cahill Boston Children's Hospital, Boston, Massachusetts , Katherine YoungKatherine Young Massachusetts Institute of Technology, Cambridge, Massachusetts , Kate HumphreyKate Humphrey Boston Children's Hospital, Boston, Massachusetts , Julie CampbellJulie Campbell Boston Children's Hospital, Boston, Massachusetts , Caitlin SchumannCaitlin Schumann Boston Children's Hospital, Boston, Massachusetts , Caleb P. NelsonCaleb P. Nelson Boston Children's Hospital, Boston, Massachusetts , Amar GuptaAmar Gupta Massachusetts Institute of Technology, Cambridge, Massachusetts , and Carlos R. EstradaCarlos R. Estrada Boston Children's Hospital, Boston, Massachusetts View All Author Informationhttps://doi.org/10.1097/JU.0000000000000750AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared virtual visits, ie remote patient encounters, via a live video system, with conventional in-person visits with respect to clinical outcomes, family experience and costs in a pediatric urology surgical population. Materials and Methods: Patients were enrolled in a prospective cohort study comparing postoperative virtual and in-person visits during a 4-month period in 2018. Appointment status and time metrics were tracked. The primary outcome was the safety of virtual visits, assessed by comparing the number of additional in-person visits, emergency department encounters and hospital readmissions. Secondary outcomes included the family assessment of the encounter and associated costs. After each visit families were prompted to complete a survey that assessed missed work/school and direct costs. Opportunity cost was estimated using reported missed work time, average national hourly wage and visit duration. Results: Overall 107 virtual and 100 in-person postoperative visits were completed. There was no difference in patient characteristics, appointment compliance or clinical outcomes between the cohorts. Travel and waiting for care accounted for 98.4% of the total time spent for an in-person visit. With the virtual visit significantly less work and school were missed by parents and children, respectively. The opportunity costs associated with an in-person visit were computed at $23.75 per minute of face time with a physician, compared to $1.14 for a virtual visit. Conclusions: For pediatric postoperative care virtual visits are associated with shorter wait times, decreased missed work and school, and clinical outcomes similar to those of in-person visits. 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See Editorial on page 22. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByFerari C, Mitchell K, Crigger C, Zupper S, Wildasin A, Ost M, Hendricks B and Al-Omar O (2021) Bridging the Gap—Building Surgical Subspecialty Telemedicine Clinics in the Rural SettingUrology Practice, VOL. 9, NO. 2, (126-133), Online publication date: 1-Mar-2022.Babar M, Zhu D, Loloi J, Laudano M, Ohmann E, Abraham N, Small A and Watts K (2022) Comparison of Patient Satisfaction and Safety Outcomes for Postoperative Telemedicine vs Face-to-Face Visits in Urology: Results of the Randomized Evaluation and Metrics Observing Telemedicine Efficacy (REMOTE) TrialUrology Practice, VOL. 9, NO. 5, (371-378), Online publication date: 1-Sep-2022.Stephany H (2020) Trends in Medicine: Virtual Visits, Now and in the FutureJournal of Urology, VOL. 204, NO. 1, (22-23), Online publication date: 1-Jul-2020. Volume 204Issue 1July 2020Page: 144-148Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordscosts and cost analysispostoperative caretelemedicineMetricsAuthor Information Julia B. Finkelstein Boston Children's Hospital, Boston, Massachusetts *Correspondence: Boston Children's Hospital, Department of Urology, 300 Longwood Ave., Hunnewell 3, Boston, Massachusetts 02115 telephone: 617-355-4490; FAX: 617-730-0474; E-mail Address: [email protected] More articles by this author Dylan Cahill Boston Children's Hospital, Boston, Massachusetts More articles by this author Katherine Young Massachusetts Institute of Technology, Cambridge, Massachusetts More articles by this author Kate Humphrey Boston Children's Hospital, Boston, Massachusetts More articles by this author Julie Campbell Boston Children's Hospital, Boston, Massachusetts More articles by this author Caitlin Schumann Boston Children's Hospital, Boston, Massachusetts More articles by this author Caleb P. Nelson Boston Children's Hospital, Boston, Massachusetts More articles by this author Amar Gupta Massachusetts Institute of Technology, Cambridge, Massachusetts More articles by this author Carlos R. Estrada Boston Children's Hospital, Boston, Massachusetts More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. See Editorial on page 22. Advertisement PDF DownloadLoading ...