American College of Surgeons endorses telehealth use in surgery

The American College of Surgeons (ACS), which includes more than 90,000 members worldwide, released a statement highlighting the critical role telehealth can play in surgical care and outlining standards for using it.

Prepared by the ACS Board of Governors Telehealth & Informatics Workgroup, the statement noted various benefits of adopting telehealth in surgical practice. These include improving access to surgical care by enabling patients in remote or underserved areas to participate in virtual consultations without traveling long distances. Telehealth also provides clinicians with quick and convenient access to surgical expertise.

In addition, telehealth empowers patients to play an active role in their healthcare journey, enables support through the continuum of care, from preoperative assessments to postoperative follow-up and survivorship, and reduces healthcare costs, according to ACS.

Telehealth in the surgical care arena is most appropriate for consultations, preoperative assessments, follow-up and monitoring, and multidisciplinary collaboration.

“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,” the statement reads.

The ACS workgroup further detailed best practices for telehealth use in surgery. Not only must surgeons adhere to all state and federal telehealth regulations, but they must also maintain a technical infrastructure that includes a secure, high-speed internet connection and user-friendly telehealth platform.

Additionally, educating surgery patients on accessing and navigating telehealth platforms and ensuring support for patients with language barriers, cultural sensitivities, and geographic and technological access limitations is crucial.

Alongside the statement, the ACS Board of Governors Telehealth & Informatics Workgroup created a primer that delves into strategies for telehealth use in surgery. The primer reviews the fundamentals of telehealth, provides recommendations to improve surgical care access through telehealth, offers practice and patient preparation considerations, and provides regulatory and financial information related to telehealth adoption. It also includes a telehealth integration checklist for surgeons.

The primer notes that a “lack of multistakeholder engagement, assessment of shared values, consensus-based prioritization of key aims and objectives, and a rigorous evaluation of the impact of telehealth on surgical healthcare outcomes” are the primary reasons for telehealth’s meager integration into surgical care.

“These deficiencies must be overcome to ensure wider and sustainable implementation of telehealth in surgery and realize its true potential as the next generation surgical healthcare delivery paradigm,” the primer states.

Research backs ACS’ embrace of telehealth. A study published in 2022 showed that telehealth decreased no-show rates among surgical patients.

The study included data from the University of Alabama Birmingham, gathered between January 2018 and December 2021. The researchers divided patient data into groups, including a control group of those with in-person visits between March 2020 and December 2021 and a group of patients scheduled for telehealth visits between March 2020 and December 2021.

Researchers found that the no-show rate was 11.7 percent in the in-person cohort, compared to only 2.5 percent in the telehealth group. A multivariable-adjusted analysis of telehealth visits revealed that telehealth reduced the likelihood of a no-show by 79 percent.

Still, surgeons remained skeptical about telehealth use in their specialty. The 2021 National Electronic Health Records Survey revealed that surgical specialists were generally less satisfied with telehealth than their primary care and medical specialty care peers.

The survey sampled 10,302 office-based physicians, of which 1,875 responded to all key items on the 2021 survey.

Only 49.5 percent of surgical specialists said they were satisfied with telehealth technology compared to 65.5 percent of primary care physicians and 63.6 percent of medical specialists.

Similarly, 49.7 percent of surgical specialists indicated that telehealth was not appropriate for their specialty or type of patients, as opposed to 15.5 percent of primary care physicians and 26.7 percent of medical specialists.