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The Knee Care Press

Weekly

Revealed: substantial benefits of telemedicine in orthopaedic surgery


A review of the opportunities & challenges for telemedicine in orthopaedics


While there is great interest in the field of telemedicine, as evidenced by a PubMed search for the term that returned > 30,000 articles, most of this interest has so far fallen outside of the field of orthopaedics. This is evidenced by a similar search for the terms telemedicine and orthopaedics/orthopedics that returned just 300 articles. (1)

Although research in this area of orthopaedics is still in its infancy, early outcomes have been promising, and the authors of this review acknowledged that “overall, there are substantial benefits to the use of telemedicine in orthopaedic surgery. The most promising of those being high patient satisfaction rates, increased patient convenience, increased access to care, decrease overheads for providers and societal cost savings.” (1)

Despite these benefits, the pre-COVID-19 use of telemedicine in orthopaedics was very low, with just 2.4% to 10% of patients utilising virtual consultations. Below are some of the challenges that have been proposed to explain this low adoption rate: (1)

· Clinicians lack knowledge about telemedicine

· Patients lack awareness of their virtual options

· Access to the necessary technology (laptop/smart phone/high speed internet)

· Costs to implement and maintain technology (hardware, software and personnel)

· Potential introduction of new inefficiencies (e.g. audio-visual delays)

· Decreased ability to perform physical examination

· Negative financial implications (reimbursement models that don’t favour telemedicine)

· Relevant regulatory barriers

The study concluded that “ultimately, the widespread use of telemedicine in orthopaedic surgery is feasible. In addition to improving the cost and quality of care, developing virtual care pathways would prepare health systems for future public-health crisis. However, successful adoption of telemedicine is contingent on coordinated initiatives between doctors, patients, insurance companies, private enterprises, and healthcare systems. By tackling the challenges of implementation and training, raising awareness and improving education, streamlining technology and collaborating with patients, providers and payers to align incentives, the field of orthopaedic surgery may benefit from telemedicine in the years to come.” (1)

For the full review article, please follow this link: http://dx.doi.org/10.2106/JBJS.20.00452

Makhni, M, C., et al. Telemedicine in Orthopaedic Surgery Challenges and Opportunities. JBJS Am. 2020; 102: 1109-15 http://dx.doi.org/10.2106/JBJS.20.00452

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