title: Telemedicine--an efficient and cost-effective approach in parathyroid surgery.
abstract: OBJECTIVE
  To demonstrate the effectiveness and cost benefit of using telemedicine for the postoperative visit in patients undergoing parathyroidectomy for primary hyperparathyroidism.
  
  
  METHODS
  Prospective noncontrolled study at a tertiary medical center of a cohort of 39 patients undergoing postoperative care after parathyroidectomy through TeleHealth at a number of sites at various distances from the primary surgical facility.
  
  
  METHODS
  From October 2006 through January 2010, 149 patients underwent parathyroidectomy for primary hyperparathyroidism at one tertiary medical center by a single surgeon. Age, sex, distance from the patient's home to the surgical center and to the TeleHealth site, effective completion of the TeleHealth visit, and postoperative complications were recorded.
  
  
  RESULTS
  Of the 149 patients who underwent parathyroidectomy, 39 had their postoperative visit using TeleHealth (26%). There were 26 females (67%) and 13 (33%) males. Mean age was 64 years. All visits were effectively carried out and completed with a nurse and the patient at a remote TeleHealth site and the surgeon at the surgical center site. There were no postoperative surgical complications noted with the visits. Average round-distance travel saved was 119 miles. The travel distance saved translated into an average savings of $357.00 per patient (which included estimations of transportation costs and lost work time), with further immeasurable benefits to the patient and healthcare system.
  
  
  CONCLUSIONS
  TeleHealth is a cost-effective and efficient way to follow-up with patients who have undergone parathyroidectomy, with significant convenience and financial benefits for the patient and healthcare system.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Marshfield, Wisconsin 54449, USA. urquhart.andrew@marshfieldclinic.org
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Urquhart
authors.forename: Nina M
authors.initials: NM
authors.lastname: Antoniotti
authors.forename: Richard L
authors.initials: RL
authors.lastname: Berg
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D016105:Parathyroidectomy / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D012720:Severity of Illness Index; D017216:Telemedicine / Q000191:economics* / Q000379:methods*; D016896:Treatment Outcome; D014481:United States