title: Prospective randomized controlled trial using telemedicine for follow-ups in an orthopedic trauma population: a pilot study.
abstract: OBJECTIVE
  To compare patient satisfaction between telemedicine and in-person follow-up appointments for orthopedic trauma.
  
  
  METHODS
  Prospective randomized controlled trial (pilot study).
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  Twenty-four patients were enrolled and randomized into 2 groups. Eight patients who had telemedicine follow-up appointments and 9 who had in-person follow-up visits were included in a per-protocol analysis. In the telemedicine group, 2 patients left the study because of nonadherence, 1 patient withdrew because of a weak Internet connection, and 1 patient sustained an open fracture. Three control patients left the study because of nonadherence.
  
  
  METHODS
  The patients had 4 follow-up appointments during a 6-month period. Patients either had their 6-week and 6-month follow-ups through video calls or in the clinic.
  
  
  METHODS
  After 6-week and 6-month follow-up appointments, the patients were given survey questions that were developed using literature-supported methods to compare follow-up experiences. The patients were monitored for complications.
  
  
  RESULTS
  There was no significant difference in patient satisfaction between telemedicine and in-person clinic visits (telemedicine: 89% satisfied; control: 100% satisfied; P = 0.74). Zero percent of patients in the telemedicine group took time off their work for their appointment compared with 55.6% in the control (P = 0.03). Telemedicine patients spent significantly less time on their visits (P = 0.01). The majority of the patients in the telemedicine group reported clear visual (87.5%) and sound quality (100%) through and agreed to future follow-up visits through telemedicine (75.0%). One patient in each group developed complications.
  
  
  CONCLUSIONS
  Telemedicine may be a viable alternative to some in-person clinic visits because of similar measures of patient satisfaction but with significantly less time and distance traveled.
  
  
  METHODS
  Therapeutic level II. See Instructions for authors for a complete description of levels of evidence.
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Nashville, TN.
authors.forename: Vasanth
authors.initials: V
authors.lastname: Sathiyakumar
authors.forename: Jordan C
authors.initials: JC
authors.lastname: Apfeld
authors.forename: William T
authors.initials: WT
authors.lastname: Obremskey
authors.forename: Rachel V
authors.initials: RV
authors.lastname: Thakore
authors.forename: Manish K
authors.initials: MK
authors.lastname: Sethi
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000601:surgery / Q000628:therapy*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D017216:Telemedicine; D016896:Treatment Outcome; D055815:Young Adult