According to an American Orthopaedic Society for Sports Medicine (AOSSM) study, sports medicine physicians have been triaging cases and using telehealth for established patients during the COVID-19 pandemic.
Sports Medicine Docs Triaging Cases, Using Telehealth During COVID
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Secondary#covid19#telehealth#triage
In the study, “How Are Orthopaedic Sports Medicine Physicians Triaging Cases and Using Telehealth in Response to COVID-19? A Survey of AOSSM Membership,” published in the March 2021 issue of Orthopaedic Journal of Sports Medicine, the researchers sought to understand how the COVID-19 pandemic has changed the practice of orthopedic sports medicine.
“It is important to understand how sports surgeons are prioritizing surgical cases during elective case restrictions and how telehealth is being incorporated into practice,” the researchers wrote.
The AOSSM Membership survey was presented to participants at the AOSSM webinar, “Handling Sports and COVID-19” and then distributed via e-mail to all members. The survey included 25 questions broken down into 3 sections: demographics, clinical practice, and telehealth.
In total, 104 members responded, and they varied in respect to their location, type of clinical practice, and years in practice. These physicians reported that the cases with the highest priority during triage included infections, fractures, and traumatic tendon ruptures.
Before COVID-19, less than 14% of surgeons used telehealth at least once a week in their practice and now 81.4% of respondents say they plan to use telehealth at least once a week in their practice.
They said that postoperative visits and return patients made the most sense for telehealth. Most said, however, it was not appropriate for new shoulder (65.9%) or knee (55.6%) evaluations.
“The leading barriers to telehealth use that were identified included, in decreasing order, concerns about clinical appropriateness, accuracy of physical examinations, billing/reimbursement, and medicolegal concerns,” the researchers wrote.
“Telehealth has seen rapid adoption during the COVID-19 pandemic, and the majority of respondents plan to continue using it. It is being used more for established patients rather than new patient visits. For surgical cases, there was a clear triage priority of sports medicine cases, including infections, fractures, and traumatic tendon ruptures. Lower extremity cases had priority than upper extremity.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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