Telehealth Utilization to Improve the Patient Care Experience within a General Surgery
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Introduction/Purpose: Patient satisfaction and quality of care are key components of the patient experience. Telehealth has been demonstrated to be an effective, safe and convenient way of providing care to postoperative patients. At the Veterans Health Administration Boston Healthcare System, approximately 20% of postoperative patients had unplanned patient-initiated contact with the medical center. A quality improvement project was carried out to evaluate whether the addition of a nurse practitioner led telehealth visit reduced the number of unplanned contacts by postoperative patients with the general surgery department. Methods: Patients were recruited through review of the general surgery operating room schedule by the principal investigator. Those patients who underwent anal procedures, colon procedures, cholecystectomy, foregut procedures and hernia procedures were offered an additional postoperative video visit. The patient supplied their email address and was scheduled for the telehealth visit utilizing the Veterans Video Connect software within the first week following surgery. Following their postoperative visit with their surgeon, their charts were reviewed to determine if there was any unplanned contact between surgery and their postoperative visit. The patients were sent a telehealth perceptions questionnaire (TMPQ) following their postoperative visit to evaluate their satisfaction with the telehealth experience. Results: There was no statistically significant difference in the number of unplanned patientinitiated contacts following the intervention. The telemedicine perception questionnaire results demonstrated that all respondents felt as satisfied talking to a nurse over VVC compared to in person. Further, 91% feel that VVC was a convenient form of healthcare delivery, and 77% feel it will be a way of healthcare delivery in the future. Discussion: Although there was no decrease in the number of unplanned patient-initiated contacts, the TMPQ data revealed that patients were satisfied with the telehealth intervention. The exact reason for the lack of decrease in the amount of unplanned contact is unknown, however it may be related to the relationship developed between the patient and PI. The patients may have felt more comfortable contacting the surgical department with their concerns. This area represents an area for future research.