• Francis Lovecchio, Grant J Riew, Dino Samartzis, Philip K Louie, Niccole Germscheid, Howard S An, CheungJason Pui YinJPYDepartment of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR, China., Norman Chutkan, Gary Michael Mallow, Marko H Neva, Frank M Phillips, Daniel M Sciubba, Mohammad El-Sharkawi, Marcelo Valacco, Michael H McCarthy, Melvin C Makhni, and Sravisht Iyer.
• Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
• Eur Spine J. 2021 Aug 1; 30 (8): 2109-2123.

PurposeTo utilize data from a global spine surgeon survey to elucidate (1) overall confidence in the telemedicine evaluation and (2) determinants of provider confidence.MethodsMembers of AO Spine International were sent a survey encompassing participant's experience with, perception of, and comparison of telemedicine to in-person visits. The survey was designed through a Delphi approach, with four rounds of question review by the multi-disciplinary authors. Data were stratified by provider age, experience, telemedicine platform, trust in telemedicine, and specialty.ResultsFour hundred and eighty-five surgeons participated in the survey. The global effort included respondents from Africa (19.9%), Asia Pacific (19.7%), Europe (24.3%), North America (9.4%), and South America (26.6%). Providers felt that physical exam-based tasks (e.g., provocative testing, assessing neurologic deficits/myelopathy, etc.) were inferior to in-person exams, while communication-based aspects (e.g., history taking, imaging review, etc.) were equivalent. Participants who performed greater than 50 visits were more likely to believe telemedicine was at least equivalent to in-person visits in the ability to make an accurate diagnosis (OR 2.37, 95% C.I. 1.03-5.43). Compared to in-person encounters, video (versus phone only) visits were associated with increased confidence in the ability of telemedicine to formulate and communicate a treatment plan (OR 3.88, 95% C.I. 1.71-8.84).ConclusionSpine surgeons are confident in the ability of telemedicine to communicate with patients, but are concerned about its capacity to accurately make physical exam-based diagnoses. Future research should concentrate on standardizing the remote examination and the development of appropriate use criteria in order to increase provider confidence in telemedicine technology.© 2020. The Author(s).

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