The statement was prepared by the Board of Governors Telehealth & Informatics Workgroup.
The American College of Surgeons (ACS) recognizes the significant role that telehealth can play in delivering high-quality surgical care through improved and equitable access, enhanced multidisciplinary collaboration, and increased efficiency. This statement serves to outline the importance of telehealth in surgical practice and to establish standards for its optimal use for the benefit of patients.
Importance of Telehealth in Surgical Practice
Post-pandemic, telehealth has emerged as a transformative tool in healthcare, and the ACS emphasizes the following potential benefits in the adoption of telehealth into surgical practice:
- Enhancing Access: Telehealth can improve access to surgical care by bridging the gap between patients and surgical providers. It eliminates the constraints of geography, enabling patients in remote or underserved areas to access surgical consultation without the burden of travel. Additionally, it enables timely access to remote surgical expertise, minimizing delays in care for time-sensitive conditions.
- Efficiency and Convenience: The adoption of telehealth can streamline healthcare delivery. Virtual consultations have the potential to minimize logistical challenges associated with in-person visits, reducing wait times, enhancing patient convenience, and expanding the surgical reach of Fellows.
- Patient-Centered Care: Telehealth empowers and encourages patients to play an active role in their healthcare journey. At-home high-definition video visits, remote patient monitoring, and advances in wearable device technologies have the potential to enhance patient engagement with their care plan, promoting satisfaction and creating alignment with treatment regimens.
- Continuity of Care: Telehealth increases the likelihood for seamless patient care, spanning the entire patient journey, from preoperative assessments to postoperative follow-up, and even, survivorship. Surgeons can consistently monitor patient progress, address concerns promptly, and provide ongoing guidance and support.
- Multidisciplinary Collaboration: Telehealth enables collaborative patient care. Surgeons connect with specialists, nurses, translators, other healthcare professionals and other stakeholders, facilitating surgeon-led comprehensive and holistic patient care, while supplementing infection control practices for all.
- Cost-Efficiency: Telehealth offers cost-effective aspects compared to traditional healthcare, reducing expenditures for both patients and institutions while potentially preserving the quality of care.
Best Practices for Utilizing Telehealth as a Surgeon
The ACS outlines best practices for surgeons to facilitate the integration of telehealth into surgical practice:
- Regulatory Compliance: Surgeons must meticulously adhere to all pertinent state and federal regulations governing telehealth practice. Remaining well-informed about evolving legislation, licensure prerequisites, reimbursement policies, security standards, and privacy regulations is imperative for ensuring full compliance.
- Technological Preparedness: Surgeons, and their supporting institutions, should maintain an appropriate technical infrastructure inclusive of a secure, high-speed internet connection and a user-friendly telehealth platform for provision of care. This infrastructure should include applications that are HIPAA compliant when appropriate and are easily accessible by patients and their families. Regular technology updates and maintenance are essential to preempt disruptions during virtual consultations.
- Patient Education: The surgical team should be proactive in educating patients and caregivers on how to optimally use telehealth. This includes providing clear instructions on accessing virtual services, preparing for telehealth appointments, and navigating telehealth platforms. Setting realistic expectations and addressing potential limitations is pivotal for ensuring a positive patient experience.
- Ethical Considerations: As in all aspects of surgical care delivery, upholding the highest ethical standards is paramount in telehealth practice. This encompasses obtaining patient consent, safeguarding patient privacy, limiting distractors and multi-tasking, and delivering remote care with the same dedication, focus, and professionalism as in-person care.
- Cultural Competence: Surgeons should approach patients from diverse backgrounds with cultural competence. Understanding potential language barriers, cultural sensitivities, geographic and technology access limitations, and healthcare beliefs ensures that care is delivered in a respectful and patient-centered manner.
When Telehealth Is Most Appropriate
The ACS promotes the use of telehealth only when it can provide the equal level of care as an in-person visit or when it is used as an adjunct to improve the overall care of the surgical patient. Telehealth is optimally employed in the following contexts:
- Consultations: Virtual consultations, including initial or new patient visits, facilitate discussions of treatment options; collaborative review of imaging and laboratory data; elucidation of surgical procedures; and addressing referring clinician and patient questions and concerns.
- Preoperative Assessments: Telehealth enables comprehensive preoperative evaluations in some clinical settings by utilizing remote consultations, enables diagnostic test reviews, and facilitates a surgical planning discussion. In some scenarios, the virtual visit can be augmented with wearable technologies and at-home diagnostics to facilitate surgical planning and achieve optimal surgical outcomes with minimization of risk.
- Follow-Up and Monitoring: Virtual visits are well suited for postoperative follow-up appointments and provide an effective means of routine monitoring of surgical patients. This offers a convenient and efficient assessment of progress or concerns and permits early intervention for potential complications. A low threshold should be maintained for requesting in-person assessment of concerns.
- Multidisciplinary Collaboration: Telehealth promotes multidisciplinary collaboration, especially in intricate surgical cases that necessitate real-time discussions and decision-making among healthcare professionals. Imaging studies, test results, and other patient data can be remotely and simultaneously reviewed and discussed by multiple members of a care team.
Telehealth is an integral component of modern surgical practice, presenting numerous advantages for both surgeons and patients. The ACS acknowledges the transformative potential of this technology. The adoption of telehealth by surgeons provides an opportunity to elevate equitable patient care, enhance healthcare outcomes, and continue the progression of surgical excellence in the digital era. A comprehensive guide to ensure its ethical and effective utilization has been developed by the Board of Governors Telehealth & Informatics Workgroup, “Unlocking the Potential of Telehealth in Surgery: A Comprehensive Primer for Surgeons.”
