Preoperative telemedicine visits are as efficient as in-person appointments in avoiding unnecessary cancellation of elective surgical procedures

Background: The COVID-19 pandemic has presented many challenges in health care, not the least of which was the need to find alternatives to an in-person evaluation in order to reduce the risk of transmission of the virus. Despite the discontinuation of elective procedures at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania in March 2020, there was a subset of patients that required urgent surgical procedures. Consequently, there needed to be a different approach to the presurgical assessment of these patients. At our institution teleconsultation had gained acceptance by patients and providers prior to the COVID-19 pandemic, therefore a program was rapidly developed utilizing teleconsultation to assess these patients. The question we sought to answer was, in patients undergoing surgery, does completing the preoperative surgical consult through teleconsultation affect the cancellation rate on the day of surgery? Method: A retrospective quantitative study was performed analyzing data from February 2019 to March 2021. The data collected from EPIC included the medical record number, DOB, gender, planned surgical case, and reason for cancellation on the day of surgery. The measured outcome was the visit cancellation rate pre and post-teleconsultation implementation. Two one-sided tests (TOST) were used to validate the equivalence of the two means. Results: The cancellation rates pre and post-implementation remained low and any difference was not statistically significant. Conclusion: Using teleconsultation as a substitute for in person evaluation did not impact the rate of same day surgical cancellation. This study suggests that teleconsultation may be a viable alternative to in person evaluation prior to surgery.