Telemedicine For Vascular Surgery Consultations

The COVID-19 pandemic has catalyzed an unprecedented need to deliver care remotely. Within just a few days of widespread advisories for social distancing and shelter-in-place mandates, there was rapid expansion of telemedicine services across specialties and sites to continue to meet patients’ ambulatory care needs. Long touted as an underused, but promising, mode of delivering care, telemedicine has become a putative “game changer” during the pandemic. An online paper writing service offers an original surgical papers crafted by our professional essay writers.

As physicians rapidly converted to either televideo or telephonic appointments, many came to realize that nearly all (or all) components of the visit were able to be completed virtually. Many have, albeit anecdotally, reported high levels of both provider and patient satisfaction with telemedicine. Indeed, the development and expansion of platforms for the delivery of virtual services and the resultant increase in capacity and/or readiness to sustain telemedicine may be a positive unintended consequence of population-wide social distancing.

However, as payers and policymakers make decisions about the future of waivers and temporary/emergent policies around the delivery of telemedicine visits, public perception of and patient satisfaction with virtual visits will be needed to inform decision making. Based on analyses of internet search volumes, it seems that broad interest in telemedicine is increasing. However, acceptance of telemedicine in the setting of the pandemic may be a consequence of the perceived risks associated with in-person visits, not to mention the nearly universal suspension of them. On the other hand, ease of access associated with telemedicine may result in sustained changes in care delivery.

We conducted this online, crowd-sourced survey to learn more about the public's willingness to use telemedicine for an initial consultation with a surgeon and to understand how their attitudes are affected by the unique factors posed by the COVID-19 pandemic.

METHODS

Survey Design

A public-facing survey was developed on a Qualtrics (Provo, UT) online platform using a modified Delphi method. A draft of the survey was developed by the investigators and then alpha-tested by 6 volunteer participants. Based on their feedback, an updated version of the survey was beta-tested on 24 volunteer participants via convenience sampling. Beta-version feedback was incorporated at this stage, and a final 43-question version of the survey was created. The survey was designed to be completed in 15 minutes or less. Always choose the best write my paper service that guarantees timely delivery.

We collected basic demographic information, including data about prior experience with the health care system (either professionally or as a surgical patient) and with telemedicine, specifically focusing on satisfaction and willingness to continue with virtual visits. The first portion of the survey was based on a five-point Likert scale and asked respondents to consider the importance of meeting their surgeon in person before the day of surgery. We also asked respondents whether certain components of an initial appointment with their surgeon would be better accomplished in person, virtually, or either way.


Then, to determine if there were differences in preferences for telemedicine under normal circumstances (before or after the pandemic) compared to the limitations imposed by social distancing, 6 different surgical scenarios of varying complexity were used: lipoma, cosmetic rhinoplasty, inguinal hernia, thyroid cancer, pancreatic cancer, and total knee replacement. Finally, survey participants were invited to comment on initial visits with a surgeon and telemedicine in a free text box.

Participant Enrollment

Participants were recruited using Amazon Mechanical Turk, or MTurk, an online crowd-sourcing marketplace which allows people to complete human intelligence tasks for small amounts of money. We restricted participation in our study to those 18 years or older who reside in the United States. We included one attention check question in the middle of the survey and excluded participants who did not answer this question correctly. We paid each participant based on the federal minimum wage for taking this 15-minute survey ($1.75).


To maximize demographic representation, and therefore generalizability of the survey results, we targeted enrollment of 2000 participants. The survey was posted on April 21, 2020 and we achieved the targeted number of responses in 4 days. Always choose the best college essay examples that guarantees quality essay work about surgical content.

RESULTS

Two thousand forty-two people responded to this survey. Seventy-nine were excluded for missing the attention check question, and 142 were excluded for entering invalid responses on questions which would indicate a lack of attentiveness to the survey questions. We therefore included 1827 responses in our final analysis.

The majority of respondents (85%) were under age 50, and 58% were male. Overall, they were well-educated, with 76% reporting at least a college degree; 27% of respondents had some medical background. The survey population tended to be employed (84% working full or part-time) and insured (87% with some form of health insurance). Only 12% of respondents were from a rural area, and most reported that they lived within 30 minutes of both their doctor's office (80%) and the nearest hospital (82%). Almost all reported compliance with social distancing measures, with 94% either not leaving home at all or going out only for essential activities.