Patient preference for time-saving telehealth postoperative visits after routine surgery in an urban setting

Abstract

Background: Focusing on high-value delivery of health care, we describe our implementation of telephone postoperative visits as alternatives to in-person follow-up after routine, low-risk surgery in an urban setting. Our pilot program assessed telephone postoperative visit feasibility as well as patient satisfaction and clinical outcomes.

Methods: We offered telephone postoperative visits to all clinically eligible, in-state patients scheduled for appropriate low-risk operations. An advanced practitioner conducted the telephone postoperative visit within 2 weeks of the operation and discharged patients from routine follow-up if recovery was satisfactory. We reviewed the medical records to identify encounters and adverse events in the 30-day postoperative period.

Results: Telephone postoperative visits were opted for by 92/94 (98%) clinically eligible, in-state patients. Most patients cited convenience (55%), travel (34%), and time (22%) as their main motivations. The average patient opting in was 55 ± 16 years old (range 23-88, 8% > 65) and lived 22 ± 26 miles from our clinic (range 0.9-124). Of 50 patients completing telephone postoperative visits, 48 (96%, 2 were not asked) were satisfied with the telephone postoperative visit as their sole postoperative visit, 44 (88%) of whom required no additional follow-up. On average, telephone postoperative visits lasted 8.6 ± 3.9 minutes, compared with the 82.8 ± 33.4 minutes for preintervention, postoperative visit time. Adding travel times, we estimate each patient saved an average of 139-199 minutes or 94-96% of the time they would have spent coming to clinic. No instances of major morbidity or mortality were identified on chart review.

Conclusion: Many patients find telephone postoperative visits more convenient than in-clinic visits. Moreover, estimates of time saved are compelling. Amid changing regulations and reimbursement, our findings support the growing use of telehealth for postoperative care of routine, low risk operations.