Telemedicine delivers clinical information and permits discussion between providers and patients at a distance. Postoperative visits may be a burden to patients—many of whom travel long distances and miss work opportunities. By implementing a telehealth opportunity, the authors sought to develop a process that optimizes efficiency and provides optimal patient satisfaction.
Using quality improvement methods that have been highly effective in the business sector, we developed a testable workflow for patients in the postoperative telehealth setting. Seventy-two patients were enrolled and surveyed. A preoperative survey sought to determine travel distance, comfort with technology, access to the Internet and video-enabled devices, and the patient’s interest in telehealth. A postoperative survey focused on patient satisfaction with the experience.
Using the Lean Six Sigma methodology, the authors developed a telehealth workflow to optimize clinical efficiency. Preoperative surveys revealed that the majority (73 percent) of patients preferred in-person follow-up visits in the clinic. However, the postoperative survey distributed after the telehealth encounter found that nearly 100 percent of patients were satisfied with the telehealth experience. Ninety-six percent of patients said that their questions were answered, and 97 percent of patients stated that they would use telehealth again in the future.
Telehealth encounters enable real-time clinical decision-making by providing patients and visiting nurses access to providers and decreasing patient transportation needs and wait times. Although initially hesitant to opt for a telehealth encounter in lieu of a traditional visit, the great majority of patients voiced satisfaction with the telehealth experience.
Lebanon and Hanover, N.H.; and New Haven, Conn.
From the Division of Plastic Surgery and The Value Institute Learning Center, Dartmouth-Hitchcock Medical Center; the Geisel School of Medicine at Dartmouth; and Yale Plastic and Reconstructive Surgery.
Received for publication May 16, 2018; accepted January 18, 2019.
Presented at the 5th Annual Surgical Trainees Advancing Research Symposium, in Lebanon, New Hampshire, April 13 through 14, 2017.
Disclosure:The authors have no financial interest to declare in relation to the content of this article. No funding was received for this article.
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John F. Nigriny, M.D., Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, N.H. 03756, firstname.lastname@example.org