Abstract
Background During the COVID-19 pandemic, the contact restrictions imposed for protection against
infection have limited the options for direct medical therapy. Considering this, the
present study aimed to evaluate the utility of the rarely used online video consultation
as an alternative treatment form for orthopedic and trauma surgeons and analyze its
potential for future use.
Methods During calendar week 24 in the year 2020, 215 specialists in orthopedics and orthopedics
and trauma surgery in the city and greater region of Hanover, Germany, were enrolled
in a questionnaire-based evaluation of their use of video consultations. The analysis
consisted of 125 completed questionnaires, which corresponded to a return rate of
58.1%. The completed questionnaires recorded the number of users, frequency of utilization,
and advantages and disadvantages of online treatment, as well as provided an assessment
of the future use of telemedicine and video consultations. Furthermore, we considered
the necessary requirements for using video consultations and for continuing their
use in the future as well as the potential of performing online consultations given
that all pertinent conditions are fulfilled.
Results Among the 125 respondents, only 17 (13.6%) had already experienced video consultations,
all starting during the COVID-19 pandemic, but with very low frequencies (maximum
of one–three times per week). Despite the limitations, the advantages included helping
patients receive the required treatments and reducing the need for travel. However,
the respondents mentioned that there were several disadvantages due to diagnostic
limitations: there was no direct examination, primary consultations were restricted,
and possibilities of consultations and explanations were reduced. Of the 108 (86.4%)
respondents who had not experienced video consultations, only 9 (8.3%) had specifically
planned to conduct online consultation, whereas 57 (52.8%) had no such intention in
the foreseeable future and 42 (38.9%) were undecided on this point. They stated diagnostic
limitations because of the lack of direct examination (44/77.2%) and the indispensable
personal contact with the
patient (30/52.6%) as main counter-arguments. According to all the respondents,
the main requirements for the implementation of video consultations included establishment
of proper technology (81.6%), adequate remuneration (61.6%), legal certainty (58.4%),
fast and unbureaucratic support for installation and in case of problems (51.2%),
and a manageable bureaucracy during the initial period (44.8%).
Conclusion Video consultations and telemedicine in general undoubtedly have advantages, primarily
concerning the protection from infection and contact restrictions, which are increasingly
requested by patients. However, the collected data indicate that this approach may
remain less important than personal consultations in the field of orthopedics and
trauma surgery. As suggested by available data, this does not apply to other fields
such as psychotherapy or general medicine.
Key words COVID-19 pandemic - online consultation - orthopedics - telemedicine - video consultation
