Results of a New Telemedicine Strategy in Traumatology and Orthopedics

Introduction: There are few studies showing results about telemedicine strategies in traumatology and orthopedics. We present a new tele-orthopedic strategy started in 2017 at the Reloncaví Health Service in Chile. Our objective was to evaluate its efficiency and impact on the orthopedic surgery specialty care waiting times of the inhabitants of the Calbuco area. Methods: We selected two general practitioners from the Calbuco Hospital who evaluated patients on the waiting list of the specialty. Synchronous connections were made between them and one orthopedic surgeon staff at the referral hospital. Connections were conducted every 2 weeks. Four to eight cases were analyzed in each session. Results: Two hundred ninety-three (n = 293) attentions were performed between June 2017 and July 2018. Highly rural patients constituted 30%. After the first evaluation by the physicians of the Calbuco Hospital, 69.6% (204/293) of the patients' consultations were resolved. The remaining 30.4% (89 patients) were presented to the specialist by telemedicine, from which 69.7% (62) required one or more follow-up connections through tele-orthopedic and 30.3% (27) were referred for on-site assessment by a subspecialist. The waiting times of the referrals decreased on average from 201 to 40 days. Discussion: This new strategy had a significant impact on the population of Calbuco, especially for the rural population. It has been possible to significantly reduce waiting list times and optimize travel times and expenditures. Only a small percentage of patients required on-site attention by a specialist after the videoconference, exhibiting the efficiency of this strategy.