Background

The COVID-19 pandemic accelerated the implementation of telehealth throughout the U.S. healthcare system. At our institution, a fully integrated multidisciplinary bariatric clinic that relied on face-to-face visits to assess and prepare patients for surgery was converted to exclusively telehealth video or telephone provider visits. We hypothesized that the need to implement telehealth would increase the number of provider encounters and delay time to surgery.

Methods

In this retrospective review, designed as a noninferiority study, patients who underwent a total telehealth approach since March 2020 were compared to the same number of consecutive patients who underwent a traditional face-to-face approach 12-months prior, using a Wilcoxon test for continuous variables and chi-square or Fisher's exact test for categorical variables. Differences between time to surgery from initial consultation and number of preoperative visits were evaluated using Hodges-Lehmann method for nonparametric distributions. The noninferiority margin for time to surgery was set to 60 days, and for number of visits set to 2.

Results

There were 23 patients in each cohort. Age, sex, BMI, comorbidities did not differ between groups. The average number of days to surgery was 73 days shorter in the telehealth group, (90% CI [-171,11]). The estimated shift in the total number of visits was an additional 1 visit in the telehealth group, (90% CI [0,1]) (Table 1).

Conclusions

The total telehealth approach to preoperative bariatric multidisciplinary workup did not delay surgery and is non-inferior to the traditional approach in terms of number of total outpatient visits and time to surgery.