A prospective, multisite study analyzing the percentage of urological cases that can be completely managed by telemedicine

Abstract

Introduction: The COVID-19 pandemic has accelerated the development of telemedicine due to confinement measures. However, the percentage of outpatient urological cases that could be managed completely by telemedicine outside of the COVID-19 pandemic remains to be determined. We conducted a prospective multisite study involving all urologists working in the region of Quebec City. Methods: During the first 4 weeks of the regional confinement, 18 pediatric and adult urologists were asked to determine after each telemedicine appointment, if it translated into a complete (CCM), incomplete (ICM), or suboptimal case management (SCM, adequate only in the context of the pandemic). Results: 1679 appointments representing all urological areas were registered.  Overall, 67.6 [65.3;69.8]%, 27.1 [25.0;29.3]% and 4.3 [3.5;5.4]% were reported as CCM, SCM and ICM, respectively.  The CCM ratio varied according to the reason for consultation, with cancer suspicion (52.9 [42.9;62.8]%) and pediatric reasons (38.0 [30.0;46.6]%) showing the lowest CCM percentages. CCM percentages also varied significantly based on the setting where it was performed, ranging from 61.1% (private clinic) to 86.8% (endourology and general hospital). Conclusion: We show that two thirds of all urological outpatient cases could be completely managed by telemedicine outside of the pandemic. After the pandemic, it will be important to incorporate telemedicine as an alternative for a patient’s first or follow-up visit, especially those with geographical, pathological and socioeconomic considerations.