From Surge to Stability: Telemedicine Use in Urology Four Years After the Pandemic

Introduction: During the COVID-19 pandemic, there was a rapid expansion of telemedicine to deliver healthcare. It was speculated that this growth would have a lasting impact on healthcare delivery, but subsequent developments suggest otherwise. This study aims to describe how telemedicine use in urology and other surgical specialties has evolved, four years post-pandemic. Materials and methods: A retrospective analysis of surgical visits at an academic health system in Hershey, Pennsylvania between July 2020 and July 2024 was conducted. Visits for Urology, General Surgery, OB/GYN, Orthopedics/Rehabilitation, Otolaryngology, and Neurosurgery were categorized as on-site, telephone, or video visits. Basic descriptives, frequencies, and one-way ANOVA were utilized to compare visit types within and between surgical specialties. Results: A total of 1,514,060 surgical visits occurred in the study period; 4.5% of which were telemedicine. Apart from Urology, all surgical specialties had a large decline in telemedicine use during this interval. Urology had the highest proportion of telemedicine use (11.3%) post-pandemic compared with other surgical specialties, including Neurosurgery (9.9%), General Surgery (8.3%), Otolaryngology (7.2%), OB/GYN (4.1%), and Orthopedics/Rehabilitation (1.2%). Urology used telephone visits (6.7%) more frequently than all other specialties, particularly Otolaryngology (0.3%, p = 0.011) and Orthopedics/Rehabilitation (0.5%, p = 0.049). On average, 88.7% of Urology visits were onsite, while telephone and video comprised 6.7% and 4.6% of visits, respectively. Conclusions: Compared with other surgical specialties, Urology has continued stable use of telemedicine, thereby encouraging continued investments in building infrastructure for this care delivery mechanism. Future efforts should be aimed at developing clinical workflows that integrate telemedicine and advocacy for permanent reimbursement policies that support sustained implementation.