Study Design
Trauma, trauma
We conducted an RCT to examine the use of telemedicine in the follow-up care of patients in orthopedic and trauma surgery at the University Hospital of Giessen, Germany, between September 2020 and April 2021. Our study design had 3 main goals: evaluation of patient and physician satisfaction, evaluation of economic and environmental impact from a societal perspective, and a health economic analysis of digitization from the hospital’s perspective. The first 2 evaluations have been previously published with a detailed description of our study design [A total of 60 patients previously treated surgically or conservatively in the clinic for various shoulder and knee conditions were recruited for the RCT in the clinic or by telephone and were randomized in a 1:1 ratio. To participate in the study, patients had to be eligible to undergo a video consultation for their follow-up appointment. Patients in the intervention group (n=30) received a 1-time follow-up appointment through an online video consultation with their attending physician. The video consultation could be conducted by patients using a digital health app or a browser-based software. If a video consultation was not possible or if further diagnostics such as imaging were needed, patients could receive a face-to-face (F2F) appointment at any time. Patients in the control group (n=30) attended their follow-up appointment conventionally in the clinic.In the Department of Trauma, Hand, and Reconstructive Surgery at the University Hospital of Giessen, a 1-hour time frame for video consultations was set up 2 days a week during regular clinic consultation hours as part of the RCT. Up to 8 telemedicine appointments were scheduled per week. Patients in both study arms were seen by the same senior physicians. These senior physicians used a laptop equipped with a camera and microphone to conduct the video consultations with a browser-based software. Although the technical equipment was already available in the clinic, additional costs in the form of monthly license fees for the use of the software occurred for the hospital during the study. Due to the simple design of the software, however, no training of the respective physicians and thus no training costs were required.