Convenience is Key for Patient Engagement with Remote Video Visits in a Musculoskeletal Practice

Document Type : RESEARCH PAPER

Authors

Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX, USA

Abstract

Background: Remote video visits (aka telemedicine, virtual care) have the potential to increase access to orthopaedic
specialty evaluation while decreasing the overall cost of care. Clinical implementation of remote video visits may benefit
from an understanding of potential barriers to participation.
Methods: We enrolled one hundred and thirty participants from a university-based musculoskeletal clinic with a large
uninsured population. We asked participants to complete a survey, including demographics and scaled perception
questions about remote video visits. Data from these surveys were analyzed with multivariable logistic regression to
determine factors associated with willingness to participate in video visits, as well as the situations in which patients
would consider a video visit.
Results: Willingness to participate in video visits was associated with the perception of video visits being more
convenient (OR 3.0) and a decreased perceived importance of physical exam (OR 0.36) but not age, technology
comfort, or travel distance to the clinic. Additionally, those with prior video visit experience were more comfortable
with technology, perceived video visits to be more convenient, and were more willing to have another video visit.
Fifteen percent were willing to have a video visit for their first visit, while 78% would participate for a routine nonsurgical
follow-up.
Conclusion: Musculoskeletal telemedicine programs can become established by focusing on people that prioritize
convenience, place less importance on a hands-on exam, and are established patients.
Level of evidence: II

Keywords

References

1. Association NRH. National Rural Health Snapshot
2016. Available from: https://www.ruralhealthweb.
org/about-nrha/about-rural-health-care#_ftn1.
2. Kangovi S, Barg FK, Carter T, Long JA, Shannon
R, Grande D. Understanding why patients of
low socioeconomic status prefer hospitals over
ambulatory care. Health affairs. 2013;32(7):1196-
203.
3. Amazon. Amazon Care: Healthcare built around you
2020. Available from: https://amazon.care/.
4. Walmart. Health Programs: Video Doctor Visits 2020.
Available from: https://one.walmart.com/content/
usone/en_us/me/health/health-programs/videodoctor-
visits.html.
5. Markwick L, McConnochie K, Wood N. Expanding
Telemedicine to Include Primary Care for the
Urban Adult. J Health Care Poor Underserved.
2015;26(3):771-6.
6. Benger JR, Noble SM, Coast J, Kendall JM. The safety
and effectiveness of minor injuries telemedicine. 
Buvik A, Bugge E, Knutsen G, Smabrekke A,
Wilsgaard T. Quality of care for remote orthopaedic
consultations using telemedicine: a randomised
controlled trial. BMC Health Serv Res. 2016;16:483.
8. Cottrell MA, O’Leary SP, Swete-Kelly P, Elwell B, Hess
S, Litchfield MA, et al. Agreement between telehealth
and in-person assessment of patients with chronic
musculoskeletal conditions presenting to an
advanced-practice physiotherapy screening clinic.
Musculoskelet Sci Pract. 2018;38:99-105.
9. Sharareh B, Schwarzkopf R. Effectiveness of
telemedical applications in postoperative followup
after total joint arthroplasty. J Arthroplasty.
2014;29(5):918-22.e1.
10. Wongworawat MD, Capistrant G, Stephenson JM. The
Opportunity Awaits to Lead Orthopaedic Telehealth
Innovation: AOA Critical Issues. J Bone Joint Surg
Am. 2017;99(17):e93.
11. Kane CK, Gillis K. The Use Of Telemedicine By 
Physicians: Still The Exception Rather Than The
Rule. Health Aff (Millwood). 2018;37(12):1923-30.
12. Powell RE, Henstenburg JM, Cooper G, Hollander JE,
Rising KL. Patient Perceptions of Telehealth Primary
Care Video Visits. Ann Fam Med. 152017. p. 225-9.
13. Baruffaldi F, Maderna R, Ricchiuto I, Paltrinieri A.
Orthopaedic specialists’ acceptance of videoconferencing
consultations. J Telemed Telecare. 2004;
10(1):59-60.
14. Bureau USC. Census - Geography Profile 2019 [cited
2019]. Available from: https://data.census.gov/
cedsci/ profile?q=&g=0100000US&table=DP05&tid=
ACSDP1Y2018.DP05&hidePreview=true.
15. Anderson D, Villagra VG, Coman E, Ahmed T, Porto A,
Jepeal N, et al. Reduced Cost Of Specialty Care Using
Electronic Consultations For Medicaid Patients.
Health Aff (Millwood). 2018;37(12):2031-6.
16. Buvik A, Bergmo TS, Bugge E, Smaabrekke A,
Wilsgaard T, Olsen JA. Cost-Effectiveness of
Telemedicine in Remote Orthopedic Consultations:
Randomized Controlled Trial. J Med Internet Res.
2019;21(2):e11330.
17. Ohinmaa A, Vuolio S, Haukipuro K, Winblad I. A costminimization
analysis of orthopaedic consultations
using videoconferencing in comparison with
conventional consulting. J Telemed Telecare. 2002;
8(5):283-9.
18. Ferucci ED, Holck P, Day GM, Choromanski TL,
Freeman SL. Factors associated with use of
telemedicine for follow-up of rheumatoid arthritis.
Arthritis Care Res (Hoboken). 2019
The Archives of Bone and Joint Surgery
Volume 9, Issue 4
July and August 2021
Pages 439-444

Files

History

  • Receive Date: 01 July 2020
  • Revise Date: 26 July 2020
  • Accept Date: 13 August 2020

Share

How to cite

Statistics