title: Efficiency, satisfaction, and costs for remote video visits following radical prostatectomy: a randomized controlled trial.
abstract: BACKGROUND
  Telemedicine in an ambulatory surgical population remains incompletely evaluated.
  
  
  OBJECTIVE
  To investigate patient encounters in the outpatient setting using video visit (VV) technology compared to traditional office visits (OVs).
  
  
  METHODS
  From June 2013 to March 2014, 55 prescreened men with a history of prostate cancer were prospectively randomized. VVs, with the patient at home or at work, were included in the outpatient clinic calendar of urologists.
  
  
  METHODS
  Remote VV versus traditional OV.
  
  
  METHODS
  An equivalence analysis was used to assess the primary outcome, visit efficiency as measured by time studies. Secondary outcomes were patient/provider satisfaction and costs.
  
  
  CONCLUSIONS
  There were 28 VVs and 27 OVs. VVs were equivalent in efficiency to relative to OVs, as measured by patient-provider face time (mean 14.5 vs 14.3min; p=0.96), patient wait time (18.4 vs 13.0min; p=0.20), and total time devoted to care (17.9 vs 17.8min; p=0.97). There were no significant differences in patient perception of visit confidentiality, efficiency, education quality, or overall satisfaction. VVs incurred lower costs, including distance traveled (median 0 vs 95 miles), travel time (0 vs 95min), missed work (0 vs 1 d), and money spent on travel ($0 vs $48; all p<0.0001). There was a high level of urologist satisfaction for both VVs (88%) and OVs (90%). The major limitation was sample size.
  
  
  CONCLUSIONS
  VV in the ambulatory postprostatectomy setting may have a future role in health care delivery models. We found equivalent efficiency, similar satisfaction, but significantly reduced patient costs for VV compared to OV. Further prospective analyses are warranted.
  
  
  RESULTS
  Among men with surgically treated prostate cancer, we evaluated the utility of remote video visits compared to office visits for outpatient consultation with a urologist. Video visits were associated with equivalent efficiency, similar satisfaction, and significantly lower patient costs when compared to office visits. We conclude that video visits may have a future role in health care delivery models.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Boyd R
authors.initials: BR
authors.lastname: Viers
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Lightner
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Marcelino E
authors.initials: ME
authors.lastname: Rivera
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Tollefson
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Boorjian
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: R Houston
authors.initials: RH
authors.lastname: Thompson
authors.affiliation: Center for Innovation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: O'Neil
authors.affiliation: Center for Innovation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Hamilton
authors.affiliation: Center for Innovation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Gardner
authors.affiliation: Center for Innovation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Bundrick
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Jenkins
authors.affiliation: Center for Innovation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Pruthi
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Igor
authors.initials: I
authors.lastname: Frank
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA. Electronic address: gettman.matthew@mayo.edu.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000379:methods*; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009819:Office Visits / Q000191:economics; D017060:Patient Satisfaction; D011182:Postoperative Care; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000191:economics; D011471:Prostatic Neoplasms / Q000191:economics / Q000601:surgery*; D012017:Referral and Consultation; D019114:Remote Consultation / Q000191:economics / Q000379:methods*; D013997:Time Factors; D013996:Time and Motion Studies; D049269:Videoconferencing / Q000191:economics; D057188:Workflow
keywords: Patient acceptance; Patient perception; Randomized controlled trial; Teleconsultation; Telehealth; Telemedicine; Urology; Video visits