The Use of Telemedicine for the Postoperative Urologic Care of Children: Results of a Pilot Program.

For postoperative visits, which are often brief interactions between family and clinician, patients may prefer the convenience of receiving postoperative care from home. We aimed to evaluate the feasibility of telemedicine for postoperative encounters in pediatric urology.

A prospective telemedicine pilot study was conducted during an implementation period from 11/10/17 to 3/22/18. All postoperative patients deemed eligible by one of four urologists were offered enrollment in the telemedicine program. Enrollees underwent at least one virtual visit within six weeks of surgery. Technical difficulties and the number of unscheduled visits and readmissions were noted. After each virtual evaluation, the family and clinician were prompted to complete a survey pertaining to their perceptions of the telemedicine experience, including how effective the virtual visit was in delivering care. For each virtual visit with a urologist, roundtrip travel cost and time were estimated.

There was 96% technical success with utilization of the software. 125 postoperative virtual visits were completed in 83 patients. The median age of children was 3.4 years and 87% were boys. Clinicians found that the virtual visit was "very effective" in 86% of cases, delivering the same care that they would have provided during an in-person visit. Families were estimated to have saved a mean of $150 of travel cost and a median of 113 minutes of travel time per visit. No adverse postoperative outcomes were observed.

This pilot study demonstrates that telemedicine can be successfully implemented in the postoperative care of pediatric urology patients.

The Journal of urology. 2019 Jan 31 [Epub ahead of print]

Julia B Finkelstein, Dylan Cahill, Michael P Kurtz, Julie Campbell, Caitlin Schumann, Briony K Varda, Rosemary Grant, Kate Humphrey, Heather Meyers, Caleb P Nelson, Carlos R Estrada

Department of Urology, Boston Children's Hospital., Innovation and Digital Health Accelerator, Boston Children's Hospital., Program for Patient Safety and Quality, Boston Children's Hospital.