U.S. plastic surgeons who developed a telehealth workflow found telehealth encounters with reconstructive patients allowed for real-time clinical decision-making, saved patients and doctors time, resulted in satisfied patients and would likely significantly reduce costs, according to a study published August 2019 in Plastic and Reconstructive Surgery.
The model could be used in aesthetic medicine for consultations and other appointments, potentially offering the same benefits with patient and provider satisfaction, according to the study’s senior author John F. Nigriny, M.D., a plastic and reconstructive surgeon at Dartmouth-Hitchcock Medical Center, and assistant professor of surgery at the Geisel School of Medicine at Dartmouth, Lebanon, N.H.
“Our study was mostly on the post-operative end, but our goal is to advance this and start using it for consultative services. It’s much easier to do that in an aesthetic practice than a practice where you’re relying on insurance payment,” Dr. Nigriny says.
Dr. Nigriny and colleagues based the model they used on the Lean Six Sigma framework, a quality improvement and defect reduction process shown to be effective in business and manufacturing, and developed a testable workflow for telehealth visits. Their process optimized clinical efficiency for remote follow-up evaluations and included cellular phone network requirements of at least 2nd generation, or 2G, technology, and a secure, encrypted videoconferencing system.
They studied 72 reconstructive patients who had the telemedicine evaluations as part of their follow-ups post reconstructive surgery.
On the day of the telemedicine sessions, a visiting nurse with specialty certification in wound care traveled to each patient's home, using an iPad to enable visual examination and communication between the plastic surgeon and patient, according to an American Society of Plastic Surgeons’ press release.
The nurse performed hands-on tasks like changing dressings and removing sutures.
But Are Patients Satisfied?
One of the big take-home messages from the findings, according to Dr. Nigriny, is that most patients embraced telemedicine after they experienced it but not before.
While younger people were more likely than older patients to embrace the thought of having a telemedicine visit, nearly 75% of all the patients surveyed before their surgeries said they would prefer to have a traditional in-person visit for their follow-up appointments.
In a follow-up survey, nearly all patients said they were satisfied with their telemedicine visits. A total of 96% said all their questions were answered during the visit and they would use the telehealth option for future follow-up care.
Adopting telemedicine is an important topic in all of medicine, including aesthetic medicine, according to Dr. Nigriny.
“The advantage of telemedicine is that it can be a lot cheaper. You don’t have to set up an office. You don’t have to employ someone to seat patients, check patients in and do all of those kinds of things. It’s pretty much the same visit visually, other than the physical exam part, but a lot of skin-related and superficial surgical practices can benefit from this,” he says.
Telemedicine is good for patients because it increases access and decreases time.
Dr. Nigriny reports no relevant disclosures.