Virtual Visits Provide Real Benefits for Orthopedic Consults

Added on Apr 30, 2018

“Telemedicine is about making the experience of care as convenient and comfortable for the patient and family as possible,” according to Dr. Alfred Atanda Jr., surgical director of the sports medicine program and pediatric orthopedic surgeon at Nemours/Alfred I. duPont Hospital for Children. Providing this high-value experience can prove challenging, but it promises major rewards for both patients and providers. 

Dr. Atanda has been using the Nemours Care Connect telehealth platform in his sports medicine practice for more than three years to reduce wait times, costs and stress for doctors, patients and families. In a study published in the Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine, he along with colleagues at Nemours and MedStar Georgetown University Hospital found that using telemedicine in a pediatric sports medicine setting provided the following benefits:

  • Reduced wait times from 30 minutes to two minutes and shortened visit times from 68 minutes to 17 minutes
  • Saved patients $50 in travel costs per visit and physicians $24 in labor costs per patient visit
  • Garnered top scores in patient experience, including 99% of survey respondents reporting that they would recommend virtual visits to other patients

These benefits are not earned simply by offering telemedicine services, Dr. Atanda stressed. They are the result of careful planning and implementation and an understanding of which patients and families will be most amenable to participating in virtual consultations. In addition to the equipment and technical training requirements, reimbursement policies and scheduling implications, providers have to consider their own communication skills and comfort level with the technology and, most important, the receptivity and tech-savviness of patients and families.

To ensure that each patient is receiving high-quality, individualized care, Dr. Atanda only offers these services to patients with whom he has established a rapport and who seem comfortable with technology and interested in virtual care. He then makes the experience as convenient as possible, often scheduling visits early in the morning, before kids go to school, or later in the evening. “That way, everyone is home, dinner is done, soccer practice is over and the focus can be solely on the child and his or her injury,” he said.

Delivering Virtual Patient-Centered Care

The same compassionate communication skills that physicians use when they are in the exam room with a patient and family should guide a telemedicine visit, according to Dr. Atanda. “During a virtual visit, I let the patient and family know I’m sitting down when I’m talking to them, not walking to the cafeteria or another meeting. I make sure I’m looking at them. If I look away to check images or their charts, I make sure to tell them so they don’t think I’m ignoring them. I try to make sure no one else is around, so it’s just me and the family chatting, without any hustle and bustle behind me,” he said.  

That doesn’t mean there won’t be any hiccups along the way, Dr. Atanda warned, noting that “technical stuff” was the biggest roadblock when he first began to use the platform in 2015. “Sometimes I logged on and couldn’t hear the patient or they couldn’t hear me; I couldn’t see them; they couldn’t figure out how to log on, or the battery of the iPad I was using died.”

To minimize the possibility of technology glitches and help prepare patients and families for their virtual visit, Nemours has since hired telemedicine coordinators who make sure families can connect and log in. These individuals play an important role in ensuring a positive experience by guiding patients along the care journey.

Dr. Atanda envisions the telemedicine coordinators’ role evolving into that of a telemedicine navigator. “I like to imagine a world where telemedicine visits bridge the gap between patients and providers. Imagine you had a telemedicine visit before an in-person visit, during which a navigator gathered all the relevant information to your current and past health so that when you arrive at the office the doctor already knows exactly why you’re there, what conditions run in the family and whatever social issues are affecting your care, and walks in and treats you.”  

In addition to strengthening the provider-to-patient connection, telemedicine has the potential to better connect providers to providers. With the mission of leveraging technology to “put patients in front of the doctors and specialists they need to be in front of,” Dr. Atanda has been piloting telemedicine consultations between providers. “The idea is that when you bring your child with knee pain to the emergency room, an orthopedist can ‘beam’ in and talk to the ER doctor and the family and potentially obviate the need for the patient to have another visit.”

The Future Is Now

Delivering the care that patients and families need, where they need it, has become a strategic imperative in today’s industry, and telemedicine is a valuable tool for facilitating that, according to Dr. Atanda.

“Telemedicine puts care right at consumers’ fingertips. The days of people making appointments, driving, parking and waiting to come and see me because they sprained their ankle—those days are going to end,” he said. “It’s only a matter of time before patients start demanding telemedicine from their providers.”

Additional Resources:
Could the Future of Health Care Include Fewer In-Person Physician Visits?
Connected Care: Advancing the Patient Experience with Telemedicine
Caring for the Caregiver: How Tele-ICUs Are Improving the Provider Experience
Small Patients, Big Technology: Leading Children’s Hospitals Are Transforming Pediatric Care with Telemedicine
Press Ganey Introduces New Telemedicine Solution for Medical Practices