Teleconsultation for preoperative evaluation during the coronavirus disease 2019 pandemic: A technical and medical feasibility study

Abstract

BACKGROUNDDuring the surge in coronavirus disease 2019 (COVID-19) infections in early 2020, many medical organisations began developing strategies for implementing teleconsultation to maintain medical services during lockdown and to limit physical contact. Therefore, we developed a teleconsultation preoperative evaluation platform to replace on-site preoperative meetings.OBJECTIVEThis study assessed the feasibility of a teleconsultation for preoperative evaluation and procedure-Associated adverse events.DESIGNImplementation study.SETTINGA tertiary care university hospital in Germany from April 2020 to October 2020.PATIENTSOne hundred and eleven patients scheduled for elective surgery.INTERVENTIONPatients were assigned to receive teleconsultation for preoperative evaluation and to complete a subsequent survey.MAIN OUTCOME MEASURESPrimary endpoints were medical and technical feasibility, user satisfaction and time savings.RESULTSFor 100 out of 111 patients, telepreoperative consultations allowed for adequate perioperative risk assessment, patient education and also for effective collection of legal signatures. For six patients (5.4%), consultations could not be started because of technical issues, whereas for five patients (4.8%), clearance for surgery could not be granted because of medical reasons. A clear majority of anaesthetists (93.7%) rated the telepreoperative evaluations as equivalent to on-site meetings. The majority of the patients considered teleconsultation for preoperative evaluation as convenient as an on-site meeting (98.2%) and would choose a teleconsultation again (97.9%). Median travel time saved by patients was 60min (Q1 40, Q3 80). We registered one adverse event: we detected atrial fibrillation in one patient only immediately prior to surgery.CONCLUSIONTelepreoperative evaluations are medically and technically feasible, yielding high satisfaction rates on both sides. However, regarding patient safety, not every patient is equally well suited. Overall, implementation of teleconsultation for preoperative evaluation into clinical routine could help maintain medical care during the COVID-19 pandemic.TRIAL REGISTRATIONNCT04518514, ClinicalTrials.gov.