Telemedicine in Cardiac Surgery: A Pilot Study
Telemedicine has been widely used in managing patients with neurologic disorders or mental illness. Telemedicine is defined as the use of medical information exchanged from one site to another via electronic communications for the health and education of the patient or healthcare provider and for the purpose of improving patient care. According to our knowledge, it has not been used to manage cardiac patients who need postoperative care after discharge from hospitals.
The use of telemedicine has the potential to reduce the cost of unnecessary travel by assessing the patient's postoperative status prior to making decisions as to whether or not a face-to-face consultation is necessary.
In this pilot study we will compare the accuracy of surgeons' decisions during follow-up visits via video-teleconference (V-Visit) to surgeons' decisions during traditional face-to-face follow-up visits (FTF-Visits). Both the V-Visit and the FTF-Visit will take place at the Houston Michael E DeBakey VA Medical Center on the same day. We will also ask both patients and providers to complete short questionnaires after each V-Visit regarding their acceptability of using telemedicine for these post-operative follow-up visits.
Information collected as part of this pilot study will be used to design a future full randomized controlled trial (RCT) on the use of telemedicine in evaluating post-operative cardiac surgical patients.
|Study Design:||Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Telemedicine in Cardiac Surgery: A Pilot Study|
- Accuracy (FTF decision on patient disposition vs. V-visit decision on patient disposition) [ Time Frame: 1 month ] [ Designated as safety issue: No ]
- Acceptability [ Time Frame: 1 month ] [ Designated as safety issue: No ]
- Feasibility [ Time Frame: 1 month ] [ Designated as safety issue: No ]
|Study Start Date:||October 2010|
|Study Completion Date:||September 2011|
|Primary Completion Date:||June 2011 (Final data collection date for primary outcome measure)|
Experimental: Arm 1
This arm will include the virtual visit clinic follow up for subjects
Procedure: Evaluative process
Evaluative process using video conferencing
No Intervention: Arm 2
This arm will include face-to-face follow up for subjects (control)
The specific aims are:
- To compare surgeons' decisions on patient disposition between V-visits and FTF-visits (gold standard).
- To assess the acceptability to patients and surgeons of using V-visits in the postoperative care of cardiac surgical patients;
- To assess the technical feasibility of using community-based outpatient clinics (CBOCs) for delivery of postoperative cardiac surgical care;
- To determine the recruitment rate for eligible subjects.
We plan to conduct this pilot study at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) in Houston, Texas, along with satellite CBOC facilities in Lufkin and Conroe. Once the accuracy, acceptability, and feasibility of the use of video conferencing (VC) in the postoperative care for cardiac surgical patients are established, we will submit a full proposal to conduct a two-arm RCT in future.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01163474
|United States, Texas|
|Michael E DeBakey VA Medical Center|
|Houston, Texas, United States, 77030|
|Principal Investigator:||Danny Chu, MD||Michael E DeBakey VA Medical Center|