Telehealth visits may be an option after surgery

People may happily, and safely, forgo in-person doctors' visits after surgery by opting instead for talking with their surgeons by phone or video, suggests a small study of U.S. veterans.

Most patients preferred the virtual visits and the doctors didn't miss any infections that popped up after surgery, the researchers report in JAMA Surgery.

"These kinds of methods are really important in the climate we're in now," said lead author Dr. Michael Vella, of Vanderbilt University Medical Center in Nashville. "So I think anything you can do to save money, see more patients and improve access to care is really important."

There is interest in so-called telehealth to increase access to healthcare while also decreasing the costs associated with traveling to office visits, Vella and his colleagues write.

Past research has found that telehealth visits may be useful in the treatment of chronic conditions and after surgery, but less is known about patients preferences for these types of visits, they add.

For the new study, the study team evaluated data collected over several months in 2014 from 23 veterans, all but one of them men, who were seen three times after a simple operation that would require only a night or so in the hospital. One visit was via video, the second was via telephone and the third was an in-person office visit.

The researchers found that no post-operation infections were missed during the video or telephone visits.

"The veterans were very good at describing their wounds," Vella said. "There was one patient who thought they were having problems, we brought them into clinic and there was an infection."

Overall, 69 percent of the participants said they preferred a telehealth visit over the traditional in-office visit. Those who preferred the telehealth visit tended to live farther away from the hospital than those who would rather come into the office.

"I think (the study) challenges the paradigm that we need to see all patients back for visits," Vella said.

He cautioned that the study was small, and they can't say telehealth visits won't miss problems. The study also can't assess how telehealth visits would work for patients who have undergone more complex surgeries.

Dr. Sherry Wren, who was not involved in the new study, also cautioned that not all patient preferences will align with the telehealth model.

"There will be patients who want to be seen, be reassured and want a doctor to check something out," said Wren, a professor of surgery at the Palo Alto Veterans Affairs Health Care System in California.

Still, she said, many patients will like the option.

"There is a subset of patient that it's not going to be appropriate for, but I think it's a great alternative for the vast majority of patients."

Vella said future research showing the results of the real-world implementation of telehealth will provide more information on its safety.

"I think it's just really important that people continue to look at it," he said.