Jessica Liu McMullin
Telemedicine – A silver lining to the COVID-19 pandemic
University of Alabama at Birmingham
covid19 pandemic caused significant changes healthcare united states across globe telemedicine rapidly adopted pandemic unique integration healthcare delivered united states generally considered one positive changes come pandemic issue american journal surgery harkey et al examined utilization virtual visits postoperative population initially randomized controlled trial prior covid19 pandemic adeptly pivoted onset pandemic becoming primary form postoperative visits1harkey k kaiser n zhao j et alutilization telemedicine provide postdischarge care comparison prepandemic vs pandemic caream j surg 2023 httpsdoiorg101016jamjsurg202303007abstract full text full text pdf pubmed scopus 2 google scholar prior pandemic patients following minimally invasive appendectomy cholecystectomy met study inclusion criteria speaking english residence state hospital system belonged email address appropriate technology complete virtual visit eligible randomization standard visit compared virtual visit following pandemic patients offered virtual visit instead randomization given need reduce risk covid19 transmission person visit except desired inperson visit unable virtual visit postoperative complication authors found statistical difference 30day hospital use two groups additionally found patients undergoing telephone calls instead video visits likely minority race hispanic ethnicity underinsured impactful work demonstrates telemedicine virtual telephone visits viable option postoperative visits appropriate patient population care continues centralize high volume centers excellence various disease processes marginalizes living rural underserved areas need travel farther order receive care high volume fellowship trained subspecialty surgeons americans living health professional shortage areas hpsa significant issues access care 44 required workforce available serve population2lussiez scott jw kunnath n dimick jb ibrahim surgical outcomes travel burden among medicare beneficiaries living health professional shortage areasam j surg 2022 224 470474httpsdoiorg101016jamjsurg202201013abstract full text full text pdf pubmed scopus 7 google scholar study lussiez et al found surgical patients living hpsa areas travel almost triple distance double travel time compared patients living hpsa areas without difference outcomes2lussiez scott jw kunnath n dimick jb ibrahim surgical outcomes travel burden among medicare beneficiaries living health professional shortage areasam j surg 2022 224 470474httpsdoiorg101016jamjsurg202201013abstract full text full text pdf pubmed scopus 7 google scholar another study authors paper found patients complete postoperative follow visit likely un underinsured additional 10 minutes travel time increased odds following 6 p 0013harkey k kaiser n inman reinke ce factors affecting postoperative followup general surgery proceduresam j surg 2018 216 10461051httpsdoiorg101016jamjsurg201809016abstract full text full text pdf pubmed scopus 8 google scholar utilization telemedicine visits reduces burden patients improves patient experience time patients receiving telemedicine postoperative visits surveyed minneapolis va respondents reported high satisfaction score mean cost savings 5194 4092 decrease travel time 994 766 minutes changes postoperative outcomes4dirnberger j waisbren efficacy telehealth visits postoperative care minneapolis vaam j surg 2020 220 721724httpsdoiorg101016jamjsurg202001015abstract full text full text pdf pubmed scopus 13 google scholar however harkey et al importantly highlight elderly population well lower socioeconomic factors language barriers may able adequately participate telemedicine based visits could lead disparities access virtual care digital literacy serves significant barrier adoption telemedicine visits effort part providers hospitals systems need placed towards assessing digital literacy prior offering telemedicine visits also improving instructions may less digitally literate order make utilization virtual visits smoother general postoperative population furthermore study virtual option available spanishspeaking patients majority study period telephone visit due limitations time resource availability interpreters provide services video visits order foster health equity conversations around support hospital systems provide aid facilitating telemedicine visits need happening help bring access opportunity populations culturally different ethnic groups may also utilize smart phone devices technology different ways authors note manuscript maintaining culturally sensitive fact well qualitative investigation differences help bring equity telemedicine covid19 pandemic drastically changed face healthcare emergence telemedicine seen silver lining otherwise devastating time society uniquely poised use opportunity develop telemedicine resource help expand access care country build tool health equity mind keep diverse needs patients forefront none none author manuscript interests disclose