Provider confidence in the telemedicine spine evaluation: results from a global study.

Lovecchio, Francis; Riew, Grant J.; Samartzis, Dino; Louie, Philip K.; Germscheid, Niccole; An, Howard S.; Cheung, Jason Pui Yin; Chutkan, Norman; Mallow, Gary Michael; Neva, Marko H.; Phillips, Frank M.; Sciubba, Daniel M.; El-Sharkawi, Mohammad; Valacco, Marcelo; McCarthy, Michael H.; Makhni, Melvin C.; Iyer, Sravisht

Purpose: To utilize data from a global spine surgeon survey to elucidate (1) overall confidence in the telemedicine evaluation and (2) determinants of provider confidence. Methods: Members of AO Spine International were sent a survey encompassing participant's experience with, perception of, and comparison of telemedicine to in-person visits. The survey was designed through a Delphi approach, with four rounds of question review by the multi-disciplinary authors. Data were stratified by provider age, experience, telemedicine platform, trust in telemedicine, and specialty. Results: Four hundred and eighty-five surgeons participated in the survey. The global effort included respondents from Africa (19.9%), Asia Pacific (19.7%), Europe (24.3%), North America (9.4%), and South America (26.6%). Providers felt that physical exam-based tasks (e.g., provocative testing, assessing neurologic deficits/myelopathy, etc.) were inferior to in-person exams, while communication-based aspects (e.g., history taking, imaging review, etc.) were equivalent. Participants who performed greater than 50 visits were more likely to believe telemedicine was at least equivalent to in-person visits in the ability to make an accurate diagnosis (OR 2.37, 95% C.I. 1.03–5.43). Compared to in-person encounters, video (versus phone only) visits were associated with increased confidence in the ability of telemedicine to formulate and communicate a treatment plan (OR 3.88, 95% C.I. 1.71–8.84). Conclusion: Spine surgeons are confident in the ability of telemedicine to communicate with patients, but are concerned about its capacity to accurately make physical exam-based diagnoses. Future research should concentrate on standardizing the remote examination and the development of appropriate use criteria in order to increase provider confidence in telemedicine technology.

TELEMEDICINE; SPINE; CONFIDENCE; PHYSICAL diagnosis; DIAGNOSIS; MEDICAL telematics

European Spine Journal, 2021, Vol 30, Issue 8, p2109

0940-6719

Academic Journal

10.1007/s00586-020-06653-8