Assessing patient usability of video visits

Attitudes and barriers toward video visits in surgical care: Insights from a nationwide survey among surgeons

BACKGROUND

Surgeons rapidly adopted video visits during the COVID-19 pandemic. However, video visit use among surgeons has significantly declined, pointing to the need to better understand current attitudes and barriers to their use in surgical care.

METHODS

From August 2022 to March 2023, a nationwide survey was conducted among practicing surgeons in 6 specialties. The survey included multiple-choice and free-response questions based on an implementation determinants framework, covering demographics, provider, patient, and organizational factors.

RESULTS

A total of 170 surgeons responded (24% response rate). Overall, 67% of surgeons said their practice lacked motivation for video visit implementation. Additionally, 69% disagreed with using video visits as the sole means for preoperative surgical consultation, even with relevant medical history, labs, and imaging. Nearly 43% cited the need for a physical examination, whereas 58% of surgeons said video visits carried a greater malpractice risk than in-person visits. Other barriers included technological limitations, billing, and care quality concerns. Nevertheless, 41% agreed that video visits could improve outcomes for some patients, and 60% expressed openness to using video visits exclusively for postoperative consultations in uncomplicated surgeries.

CONCLUSION

Surgeons recognize the potential benefits of video visits for certain patients. However, perceived barriers include the need for a physical examination, technological limitations, care quality concerns, and malpractice risks.

Augmentation of telemedicine post-operative follow-up after oculofacial plastic surgery with a self-guided patient tool

PURPOSE

This study evaluates a web-based tool designed to augment telemedicine post-operative visits after periocular surgery.

METHODS

Adult, English-speaking patients undergoing periocular surgery with telemedicine follow-up were studied prospectively in this interventional case series. Participants submitted visual acuity measurements and photographs via a web-based tool prior to routine telemedicine post-operative visits. An after-visit survey assessed patient perceptions. Surgeons rated photographs and live video for quality and blurriness; external raters also evaluated photographs. Images were analyzed for facial centration, resolution, and algorithmically detected blur. Complications were recorded and graded for severity and relation to telemedicine.

RESULTS

Seventy-nine patients were recruited. Surgeons requested an in-person assessment for six patients (7.6%) due to inadequate evaluation by telemedicine. Surgeons rated patient-provided photographs to be of higher quality than live video at the time of the post-operative visit (p < 0.001). Image blur and resolution had moderate and weak correlation with photograph quality, respectively. A photograph blur detection algorithm demonstrated sensitivity of 85.5% and specificity of 75.1%. One patient experienced a wound dehiscence with a possible relationship to inadequate evaluation during telemedicine follow-up. Patients rated the telemedicine experience and their comfort with the structure of the visit highly.

CONCLUSIONS

Augmented telemedicine follow-up after oculofacial plastic surgery is associated with high patient satisfaction, rare conversion to clinic evaluation, and few related post-operative complications. Automated detection of image resolution and blur may play a role in screening photographs for subsequent iterations of the web-based tool.

Impact of the “WeChat Cloud Service” Option for Patients in an Emergent Intensive Care Unit During an Epidemic in Tai Zhou China

To explore the application and effect of “WeChat cloud service” in the emergency intensive care unit (EICU) in the context of an epidemic, we examined 774 patients admitted to an EICU between February 2020 and June 2021. Patients admitted from February 2020 to December 2020 were selected as the control group (n = 503) and those from January 2021 to June 2021 comprised the observation group (n = 271). There were no statistically significant differences in gender, age, disease, and length of stay in the EICU between the groups. The control group received the general (routine) daily service, such as communicating with families through in-person information transmission, and receiving self-provided drugs and daily supplies during the specified visiting time; the observation group received the “WeChat cloud service” providing the chance of communication, supplies, and payment through the platform at any time. We used a T-test and χ2-test to analyse the incidence of delirium, labour costs, and patient and family satisfaction throughout ICU treatment for comparison. Results indicated that the observation group had lower labour costs, less incidence of delirium, and greater patient and family satisfaction than the control group. The “WeChat cloud service” was beneficial for preventing and controlling coronavirus disease 2019 during the epidemic and providing an improved patient experience.