The Use of Videoconferencing for Monitoring Inpatient Post-Operative Urologic Patients
The development of tablet computers and user-friendly videoconferencing applications has made telemedicine a practical tool for physicians to potentially meet the growing demands of modern healthcare. Our study aimed to compare post-operative outcomes and patient satisfaction scores among patients who are seen in person (Standard Care, SC) versus those seen via videoconferencing (VC) by their surgeon in the hospital.
Patients undergoing elective urologic surgery requiring inpatient admission were randomized to SC or VC during their hospital stay. All patients were physically examined by urology residents under the supervision of the attending surgeon at the bedside (SC) or by iPad (VC). The attending was prompted to evaluate the patient in person by any significant change in clinical status. The primary outcome was 30-day complication rate. Secondary outcomes included severity of complications, 30-day readmission rate, patient satisfaction, length of stay, number of laboratory and imaging tests obtained, and number of encounters by the attending surgeon. Two-sample t-test was used to compare continuous variables, and chi-squared or Fisher’s exact tests were used to compare categorical variables.
Of the 106 patients recruited, 102 patients were included for analysis—with 49 patients randomized to SC and 53 patients to VC. Four patients were excluded due to intraoperative findings which precluded an inpatient admission. Age, gender and racial distribution, body-mass index, Charlson-Age Comorbidity Index, American Society of Anesthesiologists scores, type of surgery, and estimated blood loss were similar between groups. There was no statistically significant difference in the overall complication rate (26.5% v 17%, p=0.24) or readmission rate (10.2% v 5.7%, p=0.39). Interestingly, the average number of laboratory tests ordered were higher in the SC group (7.2 vs 4.4, p = 0.038). Other secondary outcomes were similar between groups (see Table).
Our study demonstrates that VC rounds is a safe alternative to bedside hospital rounds in the routine care of urologic postoperative patients. Furthermore, there was no difference in patient satisfaction scores between the two groups. Telerounding is a cost effective and efficient means to manage postoperative urological inpatients.