Pilot study of telemedicine for the initial evaluation of general surgery patients in the clinic and hospitalized settings

BACKGROUND: Telemedicine has had limited implementation for general surgery. The purpose of this study was to evaluate telemedicine for the initial evaluation of patients in the clinic and hospital settings. METHODS: Synchronous telemedicine consults were conducted by a single surgeon to a rural hospital and clinic. Reasons for consult, adequacy of consult, days saved by telemedicine consult compared to standard practice, correlation of telemedicine and in-person physical exam, and number of patients who required procedures were evaluated. RESULTS: On average, patients were evaluated 7.4 days more rapidly than if the consult had been done by our standard practice. Telemedicine was adequate for all patients in this study. CONCLUSIONS: This is the first study using telemedicine for the initial consult of general surgery patients in the hospitalized and clinic setting in North America. The physical exam remains an important component of the general surgery evaluation, and special attention must be considered when structuring the telemedicine program. Telemedicine is an effective and expedient way to provide consultation for general surgery patients. Further study is needed to determine which general surgery issues are not amendable to telemedicine consultation, and to determine other surgical specialties that could utilize telemedicine in their practice.