A prospective, multisite study analyzing the percentage of urological cases that can be completely managed by telemeaicine

• Published in: Canadian Urological Association journal 2020-10, Vol.14 (10), p.319
• Main Authors: Turcotte, Bruno, Paquet, Sophie, Blais, Anne-Sophie, Blouin, Annie-Claude, Bolduc, Stephane, Bureau, Michel, Caumartin, Yves, Cloutier, Jonathan, Deschenes-Rompre, Marie-Pier, Dujardin, Thierry, Fradet, Yves, Lacombe, Louis, Moore, Katherine, Morin, Fannie, Nadeau, Genevieve, Simonyan, David, Soucy, Frederic, Tiguert, Rabi, Toren, Paul, Lodde, Michele, Pouliot, Frederic
• Format: Article
• Language: English
• Subjects: Care and treatment; Diagnosis; Evaluation; Medical care quality; Telemedicine; Urologic diseases
• ISSN: 1911-6470; 1920-1214
• DOI: 10.5489/cuaj.6862

Introduction: The COVID-19 pandemic has accelerated the development of telemedicine due to confinement measures. However, the percentage of outpatient urological cases that could be managed completely by telemedicine outside of the COVID-19 pandemic remains to be determined. We conducted a prospective, multisite study involving all urologists working in the region of Quebec City. Methods: During the first four weeks of the regional confinement, 18 pediatric and adult urologists were asked to determine, after each telemedicine appointment, if it translated into a complete (CCM), incomplete (ICM), or suboptimal case management (SCM, adequate only in the context of the pandemic). Results: A total of 1679 appointments representing all urological areas were registered. Overall, 67.6% (95% confidence interval [CI] 65.3; 69.8), 27.1% (25.0; 29.3), and 4.3% (3.5; 5.4) were reported as CCM, SCM, and ICM, respectively. The CCM ratio varied according to the reason for consultation, with cancer suspicion (52.9% [42.9; 62.8]) and pediatric reasons (38.0% [30.0; 46.6]) showing the lowest CCM percentages. CCM percentages also varied significantly based on the setting where it was performed, ranging from 61.1% (private clinic) to 86.8% (endourology and general hospital). Conclusions: We show that two-thirds of all urological outpatient cases could be completely managed by telemedicine outside of the pandemic. After the pandemic, it will be important to incorporate telemedicine as an alternative for a patient's first or followup visit, especially those with geographical, pathological, and socioeconomic considerations.