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2022-09-23 - 2022-09

Research shows that telehealth follow-up after gall bladder surgery is just as effective as in-person clinic visits A new research study by Danielle Abbitt, MD, a resident in the University of Colorado Department of Surgery, shows that a protocol that started as a necessity during the COVID-19 pandemic has evolved into a time-saving step for patients recovering from surgery. "Based on my clinical experience seeing patients, my hunch was that the results would be similar between telehealth and a clinic visit," says Abbitt, who also conducted a similar study on patients who undergo surgery to repair an inguinal hernia. "Patients are very intelligent, and they know when something is wrong with their body. If there's an issue, they'll bring it up and call the clinic. Most of the patients I see for post-op visits are doing well and don't have any complaints, but if they do, we can also address that during telehealth visits." Eliminating barriers Telehealth visits for Rocky Mountain VA patients after cholecystectomy began in spring 2020, when the COVID-19 pandemic was forcing medical facilities to close and patients were concerned about the risk of exposure during in-person visits. Cholecystectomy can be a planned procedure or an emergency operation, depending on the severity of symptoms, but in either case the follow-up is the same, Abbitt says—typically a clinic visit two weeks after the operation to check incisions and pain levels. When that follow-up appointment turned into a follow-up phone call in early 2020, she saw an opportunity to identify a permanent way to save patients time and stress by eliminating the need to drive to a follow-up appointment. "I've always been interested in access to care, and eliminating barriers to access to care, and I started thinking about interactions I've had with patients when we're in clinic," she says. "They'll apologize to me for being late, saying they had to drive two hours to be here. There's a gentleman at the VA who lives in Wyoming, in a rural area, and he's the primary caregiver for his wife. So he not only has to get himself here, but he has to get care for his elderly wife." Telehealth follow-up eases that burden, Abbitt's study found, and is just as effective at finding and addressing complications. Abbitt looked at patients who underwent cholecystectomy at the Rocky Mountain VA between August 2019 and August 2021, checking rates of post-operative complications, readmissions, emergency department visits, and the need for additional procedures. Patients who experienced a complication prior to discharge, underwent a concomitant procedure, had non-absorbable skin closure, had a new diagnosis of malignancy or were discharged home with a drain were ineligible for telehealth follow-up and excluded. The research found no significant difference in post-operative complications, emergency department utilization, 30-day readmission, or need for additional procedures between telehealth and in-person fol

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