In a given year, 48 million surgical inpatient procedures are performed. Because surgical care often requires specialized knowledge, many patients must travel beyond their local hospital or clinic to receive this needed care. But surgical care takes more than a single day at the hospital with a specialist, leaving many patients in a position to make multiple trips for care.
The surgery process is largely broken down into three phases: preoperative, intraoperative, and postoperative phase. Perioperative care occurs in the time frame before and after surgery, as the primary goal of perioperative care is to provide better conditions for patients leading up to surgery and during recovery.
Yet these before and after surgery visits can create unnecessary challenges on patients and providers.
Barriers to Care
One of these challenges is the lack of specialists in rural areas which causes patients to need to travel for their preoperative and postoperative visits. Specialized surgeons often gravitate to academic medical centers or health systems that offer opportunities for research and teaching, and this preference largely impacts rural patients. In urban areas, which more often house well-known medical centers, there are 263 specialists per 100,000 residents. Rural areas, however, count only 30 specialists per 100,000 residents—leaving patients who reside in remote areas without access to the expertise they need without travel.
This means that many patients are forced to travel not only for their actual surgery but also for their preoperative and postoperative recovery visits. For many patients, this can create financial and mobility hardships.
Telehealth Advantages for Perioperative Care
The good news is that virtual health can dissolve obstacles many patients encounter before and after surgery. Telemedicine can be utilized in perioperative patient care for:
- By having the surgical specialist connect with the patient and their local care team, telemedicine can prepare patients by answering questions, such as how to set up their house for after surgery, and ensuring that they are physically and psychologically prepared.
- Needed testing can be ordered by the remote specialist, which can be completed and shared by the local care team to provide risk assessment.
- Mental Health. By having the local care team and specialist present in preoperative visits, any surgical anxiety the patient might have can be addressed by a team they know and trust locally in partnership with a specialist.
- When complications occur it often requires patients to remain near the surgical hospital for an extended period for frequent checks. By utilizing telemedicine, patients who require frequent post-operative follow-up care can be seen virtually only returning to the surgical hospital when absolutely needed.
- Occupational Therapy. Remote therapists can help patients learn tactics to perform daily activities and reach goals, such as using a walker or putting on socks, after surgery.
- By utilizing telemedicine, we can also decrease the travel burden for patients by improving post-surgery follow up care and limiting the need for in-person wound checks.
Telehealth in preoperative and postoperative care also supplies benefits to providers. In a study of the use of telemedicine in surgical care it was found that, by implementing telemedicine services, providers were able to improve healthcare access for a much larger patient population, decrease hospital readmissions, and improve the efficiency of care.
At the University of Pittsburgh Medical Center (UPMC) surgeons are utilizing telemedicine services to remotely evaluate pre- and postoperative patients not local to their center. Telemedicine allows patients to meet their UPMC surgeon face-to-face via video, prior to the actual day of the operation, without needing to travel to Pittsburgh. By utilizing telemedicine before surgery, surgeons can evaluate patients and gather their history. After surgery, UPMC surgeons use the same telehealth service to provide postoperative care.
Connecting Providers with Data
Finally, there’s another reason telemedicine can enable preoperative and postoperative care—data sharing between providers and EHR integration. To allow for effective virtual perioperative care, without the need to repeatedly travel to distant surgical centers, it is vital to ensure that telehealth solutions are more than a simple video call and today's evidence-based telemedicine can do just that.
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