scholarly journals Implementing video visits into an orthopedic hip arthroscopy practice: a case study

2021 ◽  
Author(s):  
John Wickman ◽  
Colleen Ferlotti ◽  
Justin Ferrell ◽  
Carolyn Hutyra ◽  
Donna Phinney ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Medical Center ◽  
Quality Care ◽  
Academic Medical Center ◽  
Cost Effective ◽  
Level Of Evidence ◽  
Face To Face ◽  
Academic Medical ◽  
Clinic Visits

Abstract Telehealth videoconferencing has been shown to be feasible, cost-effective and safe in numerous fields of medicine. In an effort to increase access and improve the quality of care offered to patients we implemented a telehealth initiative allowing for remote orthopedic clinic visits at a major academic medical center. Here we report on our experience and early outcomes. A telehealth platform was launched for a single fellowship trained orthopedic surgeon at a major academic hospital in August 2018. New patients residing outside the metro area, all return patients and patients with an uncomplicated post-operative course were offered the option to complete patient encounters remotely via a telehealth platform. Each patient was offered a Patient Satisfaction Survey following video visit. Patient zip codes were used to estimate patient commutes. Ninety-six percent of patients agreed/strongly agreed with the statement ‘I was satisfied with my Telehealth experience’ while 51% agreed/strongly agreed with the statement ‘This visit was just as good as a face to face visit’. In all, 94% of patients agreed/strongly agreed with the statement ‘Having a telehealth visit made receiving care more accessible for me’. The median miles saved on commutes were 123.3 miles. The no show rate for telehealth visits was 8.2% versus 3.2% for in-person (P < 0.001). Telehealth video visits provided patients with a modality for completing orthopedic clinic visits while maintaining a high-quality care and patient satisfaction. Patient convenience was optimized with video visits with elimination of long commutes. Level of evidence: IV.

scholarly journals Deferring Routine Wrist Radiography Does Not Affect Management of de Quervain Tendinopathy Patients

2017 ◽  
Vol 07 (02) ◽  
pp. 115-120 ◽  
Author(s):  
Tiffany Liu ◽  
Chia Wu ◽  
David Steinberg ◽  
David Bozentka ◽  
L. Levin ◽  
...  
Keyword(s):  
Physical Examination ◽  
Medical Center ◽  
Academic Medical Center ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Academic Medical ◽  
De Quervain ◽  
Clinical Records ◽  
Surgical Release

Background Obtaining wrist radiographs prior to surgeon evaluation may be wasteful for patients ultimately diagnosed with de Quervain tendinopathy (DQT). Questions/Purpose Our primary question was whether radiographs directly influence treatment of patients presenting with DQT. A secondary question was whether radiographs influence the frequency of injection and surgical release between cohorts with and without radiographs evaluated within the same practice. Patients and Methods Patients diagnosed with DQT by fellowship-trained hand surgeons at an urban academic medical center were identified retrospectively. Basic demographics and radiographic findings were tabulated. Clinical records were studied to determine whether radiographic findings corroborated history or physical examination findings, and whether management was directly influenced by radiographic findings. Frequencies of treatment with injection and surgery were separately tabulated and compared between cohorts with and without radiographs. Results We included 181 patients (189 wrists), with no differences in demographics between the 58% (110 wrists) with and 42% (79 wrists) without radiographs. Fifty (45%) of imaged wrists demonstrated one or more abnormalities; however, even for the 13 (12%) with corroborating history and physical examination findings, wrist radiography did not directly influence a change in management for any patient in this series. No difference was observed in rates of injection or surgical release either upon initial presentation, or at most recent documented follow-up, between those with and without radiographs. No differences in frequency, types, or total number of additional simultaneous surgical procedures were observed for those treated surgically. Conclusion Wrist radiography does not influence management of patients presenting DQT. Level of Evidence This is a level III, diagnostic study.

Evaluation of Patient Experience from Telemedicine Use for an Anesthesiology Pain Division: Time, Cost, and Patient Satisfaction Analysis (Preprint)

2021 ◽  
Author(s):  
Laleh Jalilian ◽  
Irene Wu ◽  
Jakun Ing ◽  
Xuezhi Dong ◽  
George Pan ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Management ◽  
Travel Time ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cost Savings ◽  
Travel Distance ◽  
Patient Cost ◽  
Academic Medical ◽  
Pain Patients

BACKGROUND An increasing number of patients require outpatient and interventional pain management. To help meet the rising demand for anesthesia pain subspecialty care in rural and metropolitan areas, healthcare providers have utilized telemedicine for pain management of both interventional and chronic pain patients. OBJECTIVE This study describes telemedicine implementation for pain management at an academic pain division in a large metropolitan area. The study estimates patient cost savings from telemedicine, before and after the California COVID-19 "Safer at Home" directive, and patient satisfaction with telemedicine for pain management care. METHODS This was a retrospective, observational case series study of telemedicine use in a pain division at an urban academic medical center. From August 2019 to June 2020, we evaluated 1,398 patients and conducted 2,948 video visits for remote pain management care. We utilize publicly available IRS Statistics of Income data to estimate hourly earnings by zip code in order to estimate patient cost savings. We estimate median travel time, travel distance, direct cost of travel, and time-based opportunity savings and report patient satisfaction scores. RESULTS Telemedicine patients avoided an estimated median roundtrip driving distance of 26 miles and a median travel time of 69 minutes during afternoon traffic conditions. Within sample, the median hourly earnings was $28/hr. Patients saved a median of $22 on gas and parking and a total of $52 per telemedicine visit based on estimated hourly earnings and travel time. Patients evaluated serially with telemedicine for medication management saved a median of $156 over three visits. 91% of patients surveyed (n = 313) were satisfied with their telemedicine experience. CONCLUSIONS Telemedicine use for pain management reduced travel distance, travel time, and travel and time-based opportunity costs for pain patients. We achieved the successful implementation of telemedicine across a pain division in an urban academic medical center with high patient satisfaction and patient cost savings.

scholarly journals Comprehensive quality of discharge summaries at an academic medical center

2013 ◽  
Vol 8 (8) ◽  
pp. 436-443 ◽  
Author(s):  
Leora I. Horwitz ◽  
Grace Y. Jenq ◽  
Ursula C. Brewster ◽  
Christine Chen ◽  
Sandhya Kanade ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Discharge Summaries

scholarly journals The Experience of Hospital Death: Assessing the Quality of Care at an Academic Medical Center

2017 ◽  
Vol 35 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Elise C. Carey ◽  
Ann M. Dose ◽  
Katherine M. Humeniuk ◽  
Yichen C. Kuan ◽  
Ashley D. Hicks ◽  
...  
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Cost Effective ◽  
Hospital Death ◽  
Personal Care ◽  
Predominately White ◽  
Dying Patients

Background: The quality of perimortem care received by patients who died at our hospitals was unknown. Objective: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents’ families. Design: Telephone survey that included established measures and investigator-developed content. Setting: Large, tertiary care center known for high-quality, cost-effective care. Participants: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year. Intervention: None. Measurements: Participant perceptions of the decedent’s care, including symptom management, personal care, communication, and care coordination. Results: Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents’ anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents’ illness (29%), and receiving contradictory or confusing information (33%). Conclusion: Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.

scholarly journals Spanning the canyon between stem cell transplantation and palliative care

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 484-489 ◽  
Author(s):  
Eric Roeland ◽  
Grace Ku
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hematologic Malignancies ◽  
Cost Of Care ◽  
Academic Medical

Abstract Stem cell transplantation (SCT) and palliative care (PC) may initially appear to be distant extremes in the continuum of care of patients with hematologic malignancies, opposed by multiple obstacles preventing their integration. Rather, we will posit that both fields share many similarities and have much to learn from one another. PC has increasing relevance in cancer care given recent studies that link PC to improved quality-of-life, survival, and decreased cost of care. Understanding modern conceptualizations of PC and its role within SCT is key. Through the report of a single academic medical center experience with an integrated SCT and PC model over the last decade, we will discuss future opportunities for strengthening collaboration between SCT and PC. PC in SCT should be considered from the day of diagnosis and tied to need, not to prognosis.

Improving the Quality of Cancer Pain Management in an Academic Medical Center Emergency Department

2014 ◽  
Vol 18 (6) ◽  
pp. 626-629 ◽  
Author(s):  
Young Hwa Won ◽  
Yun Jung Choi ◽  
Shin Ahn ◽  
Jae-Lyun Lee ◽  
Jeong Yun Park ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Cancer Pain ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cancer Pain Management ◽  
Academic Medical
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