title: The impact of telemedicine in the postoperative care of the neurosurgery patient in an outpatient clinic: a unique perspective of this valuable resource in the developing world--an experience of more than 3000 teleconsultations.
abstract: Telemedicine has always been used as a teleconsultation tool in neurological emergencies (e.g., triage in head injuries, stroke, and cerebrovascular accidents). At Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India, we have been operating two teleconsultation sessions per week for the postoperative patient population, addressing routine follow-up and semiemergent conditions in this cohort of patients. At our center more than 80% of the neurosurgical procedures are conducted in patients traveling more than 1500 km. Telemedicine as a routine tool in clinical medicine has significant financial and psychosocial benefits versus routine outpatient clinics. There are very few reports of telemedicine use in routine outpatient teleconsultations in the available neurosurgical literature; those that are present do not differentiate or analyze the use in routine versus emergency neurosurgery. We discuss the role of this underused resource in the developing countries and retrospectively analyze the clinical data in more than 1500 patients and 3000 teleconsultations during a period of 6 years. We address the financial implications, psychosocial factors, and several other factors that could make this relatively modest technology an indispensible tool in current neurosurgical practice, especially in a developing country like India.
authors.affiliation: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India; Department of Neurosurgery, Australian School of Advanced Medicine, Macquarie University, New South Wales, Australia. Electronic address: ravi.dadlani@gmail.com.
authors.forename: Ravi
authors.initials: R
authors.lastname: Dadlani
authors.affiliation: Department of Healthcare informatics and Information Technology, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
authors.forename: Subramaniyan
authors.initials: S
authors.lastname: Mani
authors.affiliation: Sri Sathya Sai Central Trust, Prasanthi Nilayam, Puttaparthi, Andhra Pradesh, India.
authors.forename: Jai Ganesh
authors.initials: JG
authors.lastname: A U
authors.affiliation: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Mohan
authors.affiliation: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
authors.forename: Niranjana
authors.initials: N
authors.lastname: Rajgopalan
authors.affiliation: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Thakar
authors.affiliation: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
authors.forename: Saritha
authors.initials: S
authors.lastname: Aryan
authors.affiliation: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
authors.forename: Alangar S
authors.initials: AS
authors.lastname: Hegde
mesh_terms: D000465:Algorithms; D003906:Developing Countries; D006801:Humans; D007194:India; D009493:Neurosurgery / Q000639:trends*; D019635:Neurosurgical Procedures / Q000379:methods / Q000639:trends*; D011182:Postoperative Care / Q000379:methods / Q000639:trends*; D019114:Remote Consultation; D066231:Surgeons; D017216:Telemedicine / Q000639:trends*; D062606:Tertiary Care Centers / Q000458:organization & administration; D016896:Treatment Outcome
keywords: Neurosurgery; Outpatient; Postoperative; Socioeconomic; Teleconsultation; Telemedicine