Outcomes and Patient Reported Experience among Geriatric Patients Using Telemedicine-Based Surgical Services

INTRODUCTION: There are limited data related to patient-reported experience (PRE) with telemedicine-based perioperative care. Previously conducted national surveys have demonstrated that surgeons perceive geriatric status as a deterrent to telemedicine-based care, because these patients may lack the necessary technology literacy for successful use of this modality of care. We evaluated telemedicine-based encounters at a tertiary hernia program to determine if geriatric status was associated with differences in outcomes or PRE relative to nongeriatric patients. METHODS: Patients evaluated from August 2021 to February 2022 were prospectively surveyed. Patient characteristics, downstream care use, and PRE was compared among geriatric (age ≥ 65 years) and nongeriatric patients after telemedicine-based encounters. RESULTS: Of 91 respondents (87% response rate), 34% (n = 31) of encounters were performed for geriatric patients. Supplemental in-person evaluation was needed in 12% vs 9% (p = 0.68) of geriatric and nongeriatric patients, respectively. Compared with patient-estimated needs for an identical in-person appointment, telemedicine services among geriatric patients eliminated clinic commutes (median 49.6 km), need for hotel accommodations (0% vs 32%, p < 0.001), and reduced time off work for either themselves or family (10% vs 32%, p = 0.03). Patient-reported technical issues were similar between groups (geriatric 12.9%, nongeriatric 15.0%, p > 0.99). Eighty-five percent of all respondents reported complete satisfaction with their telemedicine-based encounter; geriatric vs nongeriatric patients did not differ for 6 assessed PRE domains (p > 0.2) or in their preference for telemedicine-based encounters in the future (81% vs 80%, p > 0.99). CONCLUSION: Perioperative telemedicine-based care yields significant benefits related to travel, work absence, and housing accommodation, with favorable PRE among geriatric populations, while providing comparable encounter outcomes.