Potential benefit of telehealth visits for postoperative care observed

There is increasing interest in telehealth as a means to improve access to care and decrease costs associated with patients traveling for traditional face-to-face encounters. This is especially important in the Veterans Health Administration patient population. Michael A. Vella, M.D., of the Veterans Affairs Medical Center and Vanderbilt University, Nashville, and colleagues conducted a study to measure the quality of telehealth visits and the preferences for post-operative general surgical care among veterans with regard to telephone, video, and in-person postoperative visits.

From May to July 2014, the researchers selected a sample of veterans undergoing operations of low complexity amenable to postoperative telehealth evaluation. Each eligible veteran was evaluated at 3 sequential visits: telephone, in-person, and video that addressed 4 domains (general recovery, follow-up needs, wound care needs, and complications). After completing all 3 types of visits, veterans were asked about their preferences regarding them.

Thirty-five veterans agreed to participate, and 23 veterans completed all 3 types of visits. There was 100 percent agreement across all 3 types of visits in the domains of general recovery and follow-up needs. Percentage of agreement for wound needs and complications was 96 percent, reflecting a possible infection reported during a telephone call that was not present during the in-person clinic or video visit. One veteran had a wound infection that was detected during telephone and video visits and confirmed during the in-person visit. There were no instances in which a wound or postoperative complication was not detected by telephone or video.

The majority of veterans (69 percent) preferred a telehealth visit (39 percent preferred the telephone, and 30 percent preferred video). Veterans who preferred telehealth visits traveled farther than those who preferred in-person visits (162 vs 75 miles).

"The data suggest that telehealth visits, either by telephone or video, can identify veterans requiring in-person assessment or further care. A telehealth follow-up program with further evaluation of patient outcomes is being trialed at our facility. This has implications for waitlist management, costs, and access to care for veterans and the Veterans Affairs health care system," the authors write.