Telemedicine for Surgical Consultations – Pandemic Response or Here to Stay?

A Report of Public Perceptions

Meredith J. Sorensen, MD, MS; Sarah Bessen, MPH; Julia Danford, BS; Christina Fleischer, BS; Sandra L. Wong, MD, MS

Disclosures

Annals of Surgery. 2020;272(3):e174-e180. 

In This Article

Methods

Survey Design

A public-facing survey was developed on a Qualtrics (Provo, UT) online platform using a modified Delphi method. A draft of the survey was developed by the investigators and then alpha-tested by 6 volunteer participants. Based on their feedback, an updated version of the survey was beta-tested on 24 volunteer participants via convenience sampling. Beta-version feedback was incorporated at this stage, and a final 43-question version of the survey was created (Appendix 1; http://links.lww.com/SLA/C309). The survey was designed to be completed in 15 minutes or less.

We collected basic demographic information, including data about prior experience with the health care system (either professionally or as a surgical patient) and with telemedicine, specifically focusing on satisfaction and willingness to continue with virtual visits. The first portion of the survey was based on a five-point Likert scale and asked respondents to consider the importance of meeting their surgeon in person before the day of surgery. We also asked respondents whether certain components of an initial appointment with their surgeon would be better accomplished in person, virtually, or either way. Then, to determine if there were differences in preferences for telemedicine under normal circumstances (before or after the pandemic) compared to the limitations imposed by social distancing, 6 different surgical scenarios of varying complexity were used: lipoma, cosmetic rhinoplasty, inguinal hernia, thyroid cancer, pancreatic cancer, and total knee replacement. Finally, survey participants were invited to comment on initial visits with a surgeon and telemedicine in a free text box.

Participant Enrollment

Participants were recruited using Amazon Mechanical Turk, or MTurk, an online crowd-sourcing marketplace which allows people to complete human intelligence tasks for small amounts of money. We restricted participation in our study to those 18 years or older who reside in the United States. We included one attention check question in the middle of the survey and excluded participants who did not answer this question correctly. We paid each participant based on the federal minimum wage for taking this 15-minute survey ($1.75). To maximize demographic representation, and therefore generalizability of the survey results, we targeted enrollment of 2000 participants. The survey was posted on April 21, 2020 and we achieved the targeted number of responses in 4 days.

This study was approved by the Dartmouth-Hitchcock Institutional Review Board (Study 02000435).

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