Telehealth vs Clinic Postoperative Visit After Hysterectomy: A Randomized Controlled Trial.

Abstract

Introduction and hypothesis: Telehealth is becoming more common, but there is a paucity of literature investigating the role of telehealth in perioperative gynecologic care. The authors hypothesized that patients evaluated via telehealth 4 weeks after minimally invasive hysterectomy would not have lower satisfaction than patients evaluated in clinic.

Methods: This was a randomized controlled noninferiority trial of patients who underwent minimally invasive hysterectomy at a single academic medical center. Participants were randomized to postoperative clinic visit or telehealth visit 4 weeks after hysterectomy. After the 4-week postoperative visit, patients were sent a satisfaction questionnaire. The primary outcome was overall patient satisfaction on a 100 mm visual analog scale. Secondary outcomes were 90-day postoperative complications and unplanned events.

Results: One hundred one patients who underwent minimally invasive hysterectomy were identified for inclusion. Complete data were collected for 47 in the clinic group and 45 in the telehealth group. Overall postoperative visit satisfaction did not differ between groups (94.3 clinic vs. 92.0 telehealth, p = 0.47). The clinic group was significantly more likely to contact the clinic two or more times (p = 0.02); both groups were similarly likely to contact the clinic at least once (57.4% vs. 51.1%). Postoperative complications did not differ between groups, nor did unplanned clinic visits or emergency department (ED) visits.

Conclusions: Postoperative visit satisfaction of patients evaluated via telehealth was noninferior to the satisfaction of patients seen in the clinic 4 weeks after minimally invasive hysterectomy. Unplanned clinic visits and ED visits did not differ between groups, nor did 90-day postoperative complications.