Telemedicine relies on mobile phone, iPad, and computer apps, as well as on Zoom and other videoconferencing applications, to bring medicine virtually – and directly — to patients in their offices or in the comfort and safety of their own homes. When used with the right patients and in the appropriate situations, telemedicine is proving comparable to in-person, in-clinic care in terms of both accurate diagnosis and treatment for a multitude of medical conditions, including non-urgent orthopedic problems and relatively minor injuries like tennis elbow, rotator cuff tears or carpal tunnel syndrome, according to Dr. Badia.
“Evidence shows that using virtual communications technologies in our medical practices is more efficient, allows for greater patient access to care, and lowers provider and patient costs, including reductions in unnecessary diagnostic tests,” says Dr. Badia, who authored the 2020 book Healthcare from the Trenches. In the book, Dr. Badia details longtime barriers to patient care in the United States.
He points to survey results, published online in September 2020 in the Journal of Bone & Joint Surgery (JBJS) Reviews, indicating that only about 20 percent of orthopedic surgeons had implemented telemedicine in their practices prior to the spread of COVID-19. But this percentage jumped to nearly 85 percent once the pandemic took hold and patients began avoiding doctors’ offices and clinics because of fears that they might catch the virus from other patients. The majority of surveyed surgeons now using telemedicine report being “satisfied” with how the technology has helped them maintain contact with patients remotely, especially for routine checkups or postoperative follow-ups, during the pandemic.
Researchers contend that COVID-19 “has led to a paradigm shift in telemedicine that is here to stay” (July 2020 issue of JBJS Reviews). “Telemedicine can serve as a [effective] medium for patient evaluation, monitoring, and interpretation of diagnostic imaging and other tests,” these experts state. And, in a June 2020 article in the Journal of Bone & Joint Surgery, authors express optimism for continuing advancements in communications technologies and ongoing progress in modifying – and validating –protocols and methods “to maximize the benefit and efficiency of the virtual orthopedic examination.”
“Telemedicine is revolutionizing the way we deliver health care across the spectrum, but particularly in orthopedics,” says Dr. Badia. “The technology enables patients, especially those sick or unable to travel, to ‘meet’ with physicians and nurses remotely. Our responsibility now as health care providers is to learn how to use telemedicine effectively to enhance its benefits.”
Dr. Badia is an early telemedicine adopter, having introduced it to his own practice – the Miami-based Badia Hand to Shoulder Center and OrthoNOW® — about five years ago.
Underscoring Dr. Badia’s comments has been a raft of recent studies emphasizing the safety, effectiveness – and accuracy of virtual orthopedic examinations, such as measuring elbow joint range of motion (February 2020 issue of the Cureus Journal of Medical Science) and range of motion of fingers (September 2020 edition of Hand New York) or assessing chronic musculoskeletal conditions involving the shoulder, knee, and lumbar spine (Musculoskeletal Science and Practice, December 2018).
Dr. Badia notes that telemedicine also is proving successful from the patient’s point of view. For example, authors of an article in an August 2020 issue of the Journal of Telemedicine and Telecare assessed the results of 14 studies and found “high rates” of clinician and patient satisfaction with telemedicine. Patients who underwent virtual interactions with physicians wanted to continue this form of communication, citing convenience of appointment times, quicker consultations, less travel, and overall time saved as reasons, the article writers state.
Of course, a successful remote “visit” to the doctor’s office does require patients to do a bit more work than simply clicking on an app or firing up the computer. Dr. Badia offers these tips to help patients prep properly for a telehealth consultation:
· First, find out whether your health insurance plan covers remote visits.
· Jot down in advance any symptoms or issues you want to discuss prior to the virtual appointment. Also, note personal health history since the last examination, such as blood pressure and types and dosages of medications you may be taking.
· Write out questions to ask the doctor.
· If using a heart monitor or other medical device, have it close at hand for ready retrieval of data.
· For orthopedic examinations, initiate the virtual visit from a relatively sparse room where, either standing or seated in a hard-backed chair, you can demonstrate movement of limbs or joints for evaluation. The surgeon can digitally measure range of motion via interactive camera.
“If we learn to use it correctly, telemedicine has the power to create a more effective, efficient and coordinated method of delivering health care in this country,” Dr. Badia concludes.
Bio: Alejandro Badia, MD, FACS, internationally renowned hand and upper-limb surgeon and founder of Badia Hand to Shoulder Center and OrthoNOW®, a walk-in orthopedic care clinic. He is a member of the American Society for Surgery of the Hand, American Association for Hand Surgery and the American Academy of Orthopedic Surgeons and an honorary member of many international professional hand societies. Dr. Badia specializes in treating all problems related to the hand and upper extremities, including trauma, sports injury, joint reconstruction, nerve injuries and arthroscopic surgeries. www.OrthoNOWcare.com and www.drbadia.com.