We sought to compare virtual visits, remote patient encounters via a live video system, with conventional in-person visits with respect to clinical outcomes, family experience and costs in a pediatric urology surgical population.
Patients were enrolled in a prospective cohort study comparing postoperative virtual and in-person visits during a four-month period in 2018. Appointment status and time metrics were tracked. The primary outcome was the safety of virtual visits, assessed by comparing the number of additional in-person visits, emergency department encounters and readmissions. Secondary outcomes included the family assessment of the encounter and associated costs. After each visit, families were prompted to complete a survey, which assessed missed work/school and direct costs. Opportunity cost was estimated using reported missed work time, average national hourly wage, and visit duration.
107 virtual and 100 in-person postoperative visits were completed. There was no difference in patient characteristics, appointment compliance or clinical outcomes between cohorts. Travel and waiting for care accounted for 98.4% of the total time spent for an in-person visit. To participate in the virtual visit, significantly less work and school was missed by parents and children, respectively. The opportunity costs associated with an in-person visit were computed at $23.75 per minute of face-time with a physician, compared to $1.14 for a virtual visit.
For pediatric postoperative care, virtual visits are associated with shorter wait times, decreased missed work and school, and similar clinical outcomes compared to in-person visits. Telemedicine appears to reduce the costs associated with these brief but important encounters.