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Implementing Real-Time Video Consultation in Plastic Surgery

  • Original Article
  • Experimental/Special Topics
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Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

The Dutch government, hospitals, and health insurance companies have agreed on concentrating all specialist care in a few expert centers. This should lead to lower healthcare costs, but might also cause less accessible healthcare for patients living at a considerable distance from expert centers. A way to overcome less accessible healthcare, while maintaining reduced costs of medical care, is by using telemedicine between physician and patient.

Methods

In a randomized controlled trial, follow-up consultation between the patient and physician via a secured real-time video connection 6 weeks after plastic surgery of the face was compared to traditional in-person consultation after the same time interval. After the consultation, patients received an invite to fill in an online survey, which consisted of questionnaires assessing patient satisfaction (PSQ-18, TSQ) and communication experiences (PEQ), as well as questions about the time spent on different aspects of the consultations.

Results

Thirty-one patients participated. Overall satisfaction was equal for both groups, but a significant difference in the dimensions ‘general satisfaction’ (online consultation group more satisfied) and ‘accessibility and convenience’ (online consultation group less satisfied) was found. Patients reported significantly lower satisfaction in patient–physician communication in online consultation than in traditional in-person consultations. Patients were satisfied with the online consultation, and were willing to use the system again. Patients in the online consultation group experienced significantly less waiting time, and spent less time in total for the appointment.

Conclusions

Overall patients are equally satisfied with traditional consultation or real-time video consultation in plastic surgery. Online consultation is found to be a time-saving alternative to traditional consultation. However, online consultation is perceived by some patients as a negative influence on communication with the physician. Dedicated training for physicians in the use of online consultation is recommended to improve their online communicative skills.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Acknowledgments

The real-time video system used in this study was provided by Visions Connected.

Author information

Authors and Affiliations

  1. Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, De Boelelaan 1117, PO Box 7057, 1007, Amsterdam, MB, The Netherlands

    I. Westra & F. B. Niessen

Authors
  1. I. Westra
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  2. F. B. Niessen
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Corresponding author

Correspondence to F. B. Niessen.

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Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Appendix

Appendix

Questionnaires

Patient Satisfaction Questionnaire-Short Form (PSQ-18)

  1. 1.

    Doctors are good about explaining the reason for medical tests…

  2. 2.

    I think my doctor’s office has everything needed to provide complete medical care …

  3. 3.

    The medical care I have been receiving is just about perfect…

  4. 4.

    Sometimes doctors make me wonder is their diagnosis is correct…

  5. 5.

    I feel confident that I can get the medical care I need without being set back financially…

  6. 6.

    When I go for medical care, they are careful to check everything when treating and examining me…

  7. 7.

    I have to pay for more of my medical care than I can afford…

  8. 8.

    I have easy access to the medical specialists I need…

  9. 9.

    Where I get medical care, people have to wait too long for emergency treatment…

  10. 10.

    Doctors act too businesslike and impersonal toward me…

  11. 11.

    My doctors treat me in a very friendly and courteous manner…

  12. 12.

    Those who provide my medical care sometimes hurry too much when they treat me…

  13. 13.

    Doctors sometimes ignore what I tell them…

  14. 14.

    I have some doubts about the ability of the doctors who treat me…

  15. 15.

    Doctors usually spend plenty of time with me…

  16. 16.

    I find it hard to get an appointment for medical care right away…

  17. 17.

    I am dissatisfied with some things about the medical care I receive…

  18. 18.

    I am able to get medical care whenever I need it…

Recorded at a five-point scale with the following values: 1 = strongly disagree, 2 = somewhat disagree, 3 = undecided, 4 = somewhat agree, 5 = strongly agree.

Patient Experience Questionnaire (PEQ)

Patient

Communication experiences

  1. 1.

    I felt reassured.

  2. 2.

    I felt that I was taken care of.

  3. 3.

    We had a good talk.

  4. 4.

    The doctor understood what was on my mind.

Communication barriers

  1. 1.

    Too much time was spent on small talk.

  2. 2.

    It was a bit difficult to ask questions.

  3. 3.

    Important decisions were made over my head.

  4. 4.

    It was a bit difficult to connect with the doctor.

Doctor

Communication experiences

  1. 1.

    I felt that the patient was reassured.

  2. 2.

    I felt that the patient was taken care of.

  3. 3.

    We had a good talk.

  4. 4.

    I understood what was on the patient’s mind.

Communication barriers

  1. 1.

    Too much time was spent on small talk.

  2. 2.

    It was a bit difficult to ask questions.

  3. 3.

    Important decisions were made over the patient’s head.

  4. 4.

    It was a bit difficult to connect with the patient.

Recorded at a five-point scale with the following values: 1 = strongly agree, 2 = agree, 3 = uncertain, 4 = disagree, 5 = strongly disagree.

Telemedicine Satisfaction Questionnaire (TSQ)

  1. 1.

    I can easily talk to my healthcare provider.

  2. 2.

    I can hear my healthcare provider clearly.

  3. 3.

    My healthcare provider is able to understand my healthcare condition.

  4. 4.

    I can see my healthcare provider as if we met in person.

  5. 5.

    I do not need assistance while using the system.

  6. 6.

    I feel comfortable communicating with my healthcare provider.

  7. 7.

    I think the healthcare provided via telemedicine is consistent.

  8. 8.

    I obtain better access to healthcare services by use of telemedicine.

  9. 9.

    Telemedicine saves me time traveling to a hospital or specialist clinic.

  10. 10.

    I do not receive adequate attention.

  11. 11.

    Telemedicine provides for my healthcare need.

  12. 12.

    I find telemedicine an acceptable way to receive healthcare services.

  13. 13.

    I will use telemedicine services again.

  14. 14.

    Overall, I am satisfied with the quality of service being provided via telemedicine.

Recorded at a five-point scale with the following values: 1 = strongly disagree, 2 = somewhat disagree, 3 = undecided, 4 = somewhat agree, 5 = strongly agree.

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Westra, I., Niessen, F.B. Implementing Real-Time Video Consultation in Plastic Surgery. Aesth Plast Surg 39, 783–790 (2015). https://doi.org/10.1007/s00266-015-0526-4

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  • DOI: https://doi.org/10.1007/s00266-015-0526-4

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