Utilizing Telemedicine in Public Health Services for the Treatment of Patients with Thoracic Surgical Conditions.

Abstract

Background: Telemedicine has been safely used across various surgical specialties at different stages of outpatient care, with effectiveness measured by clinical outcomes, cost savings, and user satisfaction. When employed for communication between physicians at a referral center and lower-complexity hospitals, it enables quick specialist evaluations for patients with relative emergencies. This study describes the experience of a tertiary care service in managing thoracic surgical conditions through telemedicine case discussions. Methods: This prospective study, from March 2022 to February 2023, focused on teleconsultations with hospitals in the referral area of a public academic hospital. Consultations were conducted synchronously and asynchronously via a proprietary platform. Data were collected on the originating hospital, patient demographics, admission date, diagnosis, and clinical summary. Cost savings were calculated by estimating avoided round-trip ambulance transportation. The analysis included data from the public health system's referral records. Results: Out of 4,386 evaluation requests, 341 (7.7%) were discussed with a thoracic surgery specialist. Of these, 181 (53%) were managed without patient transfer, and 53 required rediscussion to revisit the initial medical approach. Immediate transfer, outpatient evaluation, or surgery was recommended in 160 cases. Conclusion: The incorporation of telemedicine into interhospital regulation of thoracic surgical diseases effectively reduced unnecessary patient transfers while providing the originating service with valuable information for managing specialty-specific situations.