Accuracy of telemedicine for the diagnosis and treatment of patients with shoulder complaints

Abstract

Background: Minimal data is available on the accuracy of diagnoses for orthopaedic shoulder complaints developed via telemedicine consultations. We hypothesize that evaluating surgeons can accurately diagnose and treat shoulder pathology via telemedicine evaluation. Methods: Patient evaluations for new shoulder complaints via telemedicine were retrospectively reviewed. Records were kept of all new patients seen via telemedicine, and all patients were advised to follow-up for in-person evaluation. All patients with in-person follow-up were included in final analysis. Changes in diagnosis or treatments were noted at time of in-person evaluation. Results: Eighty-two patients completed both telemedicine and in-person evaluation. 44 (53.6%) had no changes in diagnosis or treatment, and 22 (26.8%) had no change in diagnosis with advancement in treatment. Sixteen patients (19.5%) had a change in diagnosis or treatment. Of the 16 patients where changes were made, 9 patients were given additional diagnoses, and 7 patients had changes in their diagnosis at time of in-person follow-up. Two (2.4%) patients had a change in treatment resulting from the in-person visit. Fifty-seven patients (69.5%) had imaging (X-ray, MRI, or CT) available during the telemedicine visit. Conclusions: Telemedicine was an effective platform for evaluating patients with new shoulder complaints, with only 2.4% of treatments altered after in-person evaluation. There may be specific shoulder pathology that is more difficult to diagnose via telemedicine or without advanced imaging. Further research evaluating patient and surgeon satisfaction with telemedicine is underway. Level of Evidence: IV, Retrospective Cohort Study.