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Interventional procedure plans generated by telemedicine visits in spine patients are rarely changed after in-person evaluation
  1. Alexander M Crawford1,
  2. Harry M Lightsey1,
  3. Grace X Xiong1,
  4. Brendan M Striano1,
  5. Nattaly Greene1,
  6. Andrew J Schoenfeld2 and
  7. Andrew K Simpson2
  1. 1Harvard Combined Orthopaedic Residency Program, Boston, Massachusetts, USA
  2. 2Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Andrew K Simpson, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA; asimpson{at}bwh.harvard.edu

Abstract

Background and objectives The role of telemedicine in the evaluation and treatment of patients with spinal disorders is rapidly expanding, brought on largely by the COVID-19 pandemic. Within this context, the ability of pain specialists to accurately diagnose and plan appropriate interventional spine procedures based entirely on telemedicine visits, without an in-person evaluation, remains to be established. In this study, our primary objective was to assess the relevance of telemedicine to interventional spine procedure planning by determining whether procedure plans established solely from virtual visits changed following in-person evaluation.

Methods We reviewed virtual and in-person clinical encounters from our academic health system’s 10 interventional spine specialists. We included patients who were seen exclusively via telemedicine encounters and indicated for an interventional procedure with documented procedural plans. Virtual plans were then compared with the actual procedures performed following in-person evaluation. Demographic data as well as the type and extent of physical examination performed by the interventional spine specialist were also recorded.

Results Of the 87 new patients included, the mean age was 60 years (SE 1.4 years) and the preprocedural plan established by telemedicine, primarily videoconferencing, did not change for 76 individuals (87%; 95% CI 0.79 to 0.94) following in-person evaluation. Based on the size of our sample, interventional procedures indicated solely during telemedicine encounters may be accurate in 79%–94% of cases in the broader population.

Conclusions Our findings suggest that telemedicine evaluations are a generally accurate means of preprocedural assessment and development of interventional spine procedure plans. These findings clearly demonstrate the capabilities of telemedicine for evaluating spine patients and planning interventional spine procedures.

  • injections
  • spinal
  • diagnostic techniques and procedures
  • back pain

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Footnotes

  • AMC and HML contributed equally.

  • Contributors All authors included made substantial contributions to the conception and/or design of the study, acquisition of data and/or analysis and interpretation of data. We believe that the effort of each of these researchers warrants a position on the author list.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Patient data obtained through Institutional Review Board and not publicly available.

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