The impact of telehealth on non-scheduled post-operative patient contacts and administrative burden
Brett Baker, Piyush Gupta, Tiare Pimentel, Reuben Shin, Heather Ford, Thomas Schnelldorfer, David M. Brams, Dmitry Nepomnayshy
General Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts, United States
Objective: The aim of this study is to quantify and characterize unscheduled, patient-initiated contacts in postoperative bariatric patients, comparing data from before and after conversion of preoperative encounters to telehealth.
Design: Retrospective database and chart review of all bariatric patients who underwent surgical intervention from August to December in 2019 and 2020.
Setting: Tertiary-care, academic teaching hospital.
Patients: All patients who underwent bariatric surgery August to December in 2019 and 2020.
Interventions: None.
Main Outcome Measures: Total patient-initiated clinic contacts in the first 30 days postoperatively, classification of topics addressed, statistical analysis to evaluate for differences before and after COVID-driven conversion to preoperative telehealth encounters.
Results: A total of 220 patients were included in the analysis, 100 patients who had only in-person preoperative visits and 120 patients who had only telehealth encounters. The baseline demographics, procedural composition, and length of stay were similar between groups. Overall, 62% of patients had at least one unscheduled contact post-operatively, which was consistent on group-level analysis. The total volume of unscheduled clinic contacts were comparable, but the balance between phone calls and EMR patient messaging shifted toward the latter in the telehealth population. No statistically-significant differences were found between groups in terms of topics of patient inquiry, most commonly regarding postoperative symptomatology or diet clarification. Though the frequency of patients making early contact was similar across procedures, sleeve gastrectomy patients were responsible for a higher volume of contacts per patient as compared to other procedures.
Conclusions: Telehealth represents a convenient and viable alternative to in person visits without significant impacts on patient education or administrative burden. Continual evaluation of postoperative patient questions can allow for optimization of educational approaches to improve patient experience and reduce administrative burden.
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