Telehealth in Plastic Surgery

A Veterans Affairs Hospital Perspective

Stephanie Douglas, MD; Erik Geiger, MD; Andrew McGregor, MD; Amanda Norwich, MD; Deena Abbate, RN; Henry Hsia, MD; Deepak Narayan, MD

Disclosures

Plast Reconstr Surg Glob Open. 2018;6(10):e1840 

In This Article

Methods and Materials

Patients

This is a cross-sectional mixed methods study with patient questionnaires using quantitative and qualitative measures to assess patient satisfaction with a service. Patients with initial consultation for lesions or complaints that could be addressed using local anesthesia or subsequent low risk operations were considered. Exclusion criteria included dementia, severe visual, auditory, and cognitive impairment, need for a translator, and need for extensive medical and cardiac evaluation before general anesthesia. Surgical emergencies were ineligible. All plastic surgery consultations were reviewed by a nurse coordinator for eligibility, and those patients who qualified were given the option of participating. Patients were consented for a telemedicine consultation as mandated by Connecticut law.

Facilities, Equipment, and Personnel

Patients who met the CVT eligibility criteria presented to a participating CBOC. Seven CBOCs in Connecticut and 3 CBOCs in Massachusetts participated. Patient-side examination rooms were equipped with the i8500 Mobile Telemedicine Station from Global Med (Scottsdale, Ariz.), which is outfitted with video conferencing equipment and a stethoscope, 12-lead electrocardiogram, ultrasound probe, dermatoscope, and otoscope that transmit medical data to a clinician in a remote location. A medical assistant or nurse was in the room with the patient and operated the telemedicine equipment. Patients were connected to a plastic surgeon located at the VA facility in West Haven, CT, over the VA video enterprise network. Provider-side equipment was the GlobalMed "Education Station" equipped with a large 42-inch HP touchscreen monitor and standard telemedicine equipment. Information technology support for the CVT program was provided by Iron Bow Technologies (Chantilly, Va.).

Data Collection

Following their initial encounter, patients completed a questionnaire (Supplemental Digital Content 1, which displays a telehealth questionnaire, http://links.lww.com/PRSGO/A848) detailing factors influencing their decision whether to participate in the CVT program and their level of satisfaction with their "visit." (see pdf, Supplemental Digital Content 1, which displays a telehealth questionnaire, http://links.lww.com/PRSGO/A848).

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