Telemedicine practices in otolaryngology: a single centre study

Background: Telemedicine (TM) was rapidly integrated into routine outpatient care at many centres during the coronavirus disease 2019 (COVID-19) pandemic. This technology provided a means of continuing to offer patient care while minimising infection transmission. While the acute period of infectious risk has passed, this study aims to examine patient characteristics and appointment outcomes during this time, with a view to considering ongoing applications of TM in otolaryngology clinics.

Methods: A retrospective observational cohort study was conducted on patients at a single centre in Melbourne, Australia over a 6-month period between March 2020 and August 2020. Data collected included patient demographics, subtype of otolaryngology consultation, interventions and attendance and planned follow-up patterns. Patient and visit characteristics were assessed and compared for TM vs. face-to-face (F2F) consultations.

Results: The study included 1,118 appointments at a general otolaryngology clinic during the assessment period. There was no significant difference in attendance and discharge rates between TM and F2F appointments. Telehealth patients were less likely to be new patients than F2F patients (25.9% vs. 41.8%). There was a significant association between consultation mode and new vs. review status [odds ratio 0.49, 95% confidence interval (CI): 0.38–0.63, P<0.001]. Scheduled follow-up periods were shorter in the F2F group with a median of 10 weeks [interquartile range (IQR), 3–23.5 weeks] vs. 16 weeks (IQR, 8–26 weeks) in the TM group. Appointments with an interpreter had shorter follow-up arranged by 4.3 weeks independent of appointment modality (95% CI: 0.42–8.12, P=0.03).

Conclusions: Mode of delivery of appointment (TM vs. F2F) did not appear to impact attendance and discharge rates in otolaryngology outpatient clinics. Assessing the utility of postoperative reviews via TM was limited by the significantly reduced operative rates during the pandemic and further research outside this period is required. This study suggests that TM has a role in furthering patient care when used in the appropriate setting but can pose challenges in certain patient populations, including patients requiring interpreter services.