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Post-operative Care & Long-term Follow-up
Using Telemedicine
Analysis of Social & Financial Impact
Anjali Mishra
Additiona...
Telemedicine & Surgical Patients
• Teleconsultation
• Pre-referral screening
• Telementoring/ Telesurgery
• Post-operative...
Post-operative Care & Long-term
Follow-up
Transforming Health Care With IT
Reasons for Post-operative Visits
• Wound & general care
– Suture Removal
– Pain, Infection, Bleeding
– Nutrition
– Medica...
Issues
• Inconvenience/ Anxiety
• Financial loss
• Work hour loss
• Leave issues
• Domestic/ social issues
Transforming He...
Tele Follow-up
• Well established for some medical conditions
– Chronic diseases
• Cardiology
• Neurology
– Web based trea...
SGPGIMS Experience
Transforming Health Care With IT
Transforming Health Care With IT
Aims & Objectives
• Pilot study was undertaken to assess the
feasibility of tele-follow u...
Materials & Methods
• April 2004 –December 2007
• Follow- up data of patients, operated at our center &
thereafter consent...
Transforming Health Care With IT
Procedure
• First tele-follow up appointment fixed at the time of
discharge after explaining the procedure to the
patient
...
Transforming Health Care With IT
Photograph
Transforming Health Care With IT
Transforming Health Care With IT
Telemedicine Center
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow
TELE-FOLLOW UP
Name : Ayesha Mohanti...
Reasons For Teleconsultations
• Review of histology report : 18 (53.0)
– Further visits not required : 13 (72.2)
• Dosage ...
Financial Implications
Transforming Health Care With IT
Outcome
• Satisfaction
– Excellent : 69%
– Very good : 31%
• Leave saved
– Per visit : 7.2 (4-12) days
– Per patient : 14....
Transforming Health Care With IT
Transforming Health Care With IT
Care Continuum So Far
• No of Patients (April 2004- June 2013): 88
• Age: 44.3 + 13.8 years; M: F=1:1.8
• Diagnosis
– Thyr...
Care Continuum- Changing Needs
• Indications of first follow- up visit
– Review of final histology
– Medicine dosages adju...
Summary
• Indications: Clean, low risk surgeries
– Laparaoscopic cholecystectomy, Hernia surgery
– Skin & superficial surg...
Conclusions
• We believe that tele-follow up facility could play an
important role in improving health care delivery
syste...
Transforming Health Care With IT
Thank You
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Post-operative Care & Long-term Follow-up Using Telemedicine Analysis of Social & Financial Impact

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Transcript of "Post-operative Care & Long-term Follow-up Using Telemedicine Analysis of Social & Financial Impact"

  1. 1. Post-operative Care & Long-term Follow-up Using Telemedicine Analysis of Social & Financial Impact Anjali Mishra Additional Professor Dept of Endocrine Surgery, SGPGIMS, Lucknow- 226014, India Transforming Health Care With IT
  2. 2. Telemedicine & Surgical Patients • Teleconsultation • Pre-referral screening • Telementoring/ Telesurgery • Post-operative care (tele- follow up) Transforming Health Care With IT
  3. 3. Post-operative Care & Long-term Follow-up Transforming Health Care With IT
  4. 4. Reasons for Post-operative Visits • Wound & general care – Suture Removal – Pain, Infection, Bleeding – Nutrition – Medication’s dosages adjustment • Histology (biopsy) reports • Further planning • Long- term follow up Transforming Health Care With IT
  5. 5. Issues • Inconvenience/ Anxiety • Financial loss • Work hour loss • Leave issues • Domestic/ social issues Transforming Health Care With IT
  6. 6. Tele Follow-up • Well established for some medical conditions – Chronic diseases • Cardiology • Neurology – Web based treatment planning for radiotherapy • Surgery emerging Transforming Health Care With IT
  7. 7. SGPGIMS Experience Transforming Health Care With IT
  8. 8. Transforming Health Care With IT Aims & Objectives • Pilot study was undertaken to assess the feasibility of tele-follow up in post-operative cases of thyroid and parathyroid disorders, to establish the indications of the same, and to know the outcome in terms of patient satisfaction, financial and work hour savings incurred by them
  9. 9. Materials & Methods • April 2004 –December 2007 • Follow- up data of patients, operated at our center & thereafter consenting to report at telemedicine center Cuttack for tele-consultations analyzed – Nature of Surgery – Reason of consultation • A questionnaire was given to pts.to assessed – Patient’s satisfaction – Financial savings – Leave saved Transforming Health Care With IT
  10. 10. Transforming Health Care With IT
  11. 11. Procedure • First tele-follow up appointment fixed at the time of discharge after explaining the procedure to the patient • On the day of appointment, telemedicine staff contacted the Senior Resident in Endocrine Surgery. • Patients records and required reports eg: Histology retrieved from HIS & placed in a file Transforming Health Care With IT
  12. 12. Transforming Health Care With IT Photograph
  13. 13. Transforming Health Care With IT
  14. 14. Transforming Health Care With IT
  15. 15. Telemedicine Center Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow TELE-FOLLOW UP Name : Ayesha Mohanti Cr No : 2004113413 Diagnosis: Post-Op Case of Minimally Invasive Follicular Carcinoma Date: 11.04.05 Tele-Follow No.: 4th Clinical Status: No symptoms Investigation Report received: Serum Tg. <0.5 ng/ml Advice: Continue Tab. Eltroxin 100 ugm. Daily as advised Serum TSH estimation Next Follow-up: After six months with serum Thyroglobulin and Serum TSH Doctor’s Name: Dr. S.K. Mishra Transforming Health Care With IT
  16. 16. Reasons For Teleconsultations • Review of histology report : 18 (53.0) – Further visits not required : 13 (72.2) • Dosage adjustment : 27 (79.4) – Thyroxin dose adjustment : 24 – Calcium dosage adjustment : 08 • Thyroid cancer follow-up : 05 (14.7) Transforming Health Care With IT
  17. 17. Financial Implications Transforming Health Care With IT
  18. 18. Outcome • Satisfaction – Excellent : 69% – Very good : 31% • Leave saved – Per visit : 7.2 (4-12) days – Per patient : 14.5 days • Would prefer tele-follow-up Transforming Health Care With IT
  19. 19. Transforming Health Care With IT
  20. 20. Transforming Health Care With IT
  21. 21. Care Continuum So Far • No of Patients (April 2004- June 2013): 88 • Age: 44.3 + 13.8 years; M: F=1:1.8 • Diagnosis – Thyroid carcinoma : 49.3% – Benign thyroid diseases : 40.2% – Primary hyperparathyroidism : 08.0% – Adrenal Disorders : 02.3% • Duration of follow up (months) : 1 - 90 > 24 months : 21.3% • Median no. of visits/ patient : 2 ( 1-13) > 5 visits : 22.7% Transforming Health Care With IT
  22. 22. Care Continuum- Changing Needs • Indications of first follow- up visit – Review of final histology – Medicine dosages adjustment • Indication of subsequent follow- up visits – Medicine dosages adjustment – Tumour surveillance Transforming Health Care With IT
  23. 23. Summary • Indications: Clean, low risk surgeries – Laparaoscopic cholecystectomy, Hernia surgery – Skin & superficial surgeries – Thyroidectomy & parathyroidectomy • Benefits – Permit better resource utilization – Early and safe discharge – Can support Rural, remote, mobile surgery – Good follow up ensured Transforming Health Care With IT
  24. 24. Conclusions • We believe that tele-follow up facility could play an important role in improving health care delivery system in our country Transforming Health Care With IT
  25. 25. Transforming Health Care With IT Thank You
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