INTRODUCTION: The COVID-19 pandemic has significantly impacted patients and health care systems around the globe. Hospitals cancelled elective surgeries and telemedicine was adopted as a common tool to keep providing care while minimizing patients' risk of exposure to SARS-CoV-2. METHODS: To respond to the spread of SARS-CoV-2 we implemented several measures to contribute to flattening the COVID-19 curve. Our neurosurgery department performed an evaluation of the upcoming clinic visits, and either converted to telemedicine or rescheduled patients that were considered not to be significantly impacted by a postponement. Until March 2020 almost 100% of our clinic visits were face-to-face, in April 55% of our clinic visits were via telemedicine. Telemedicine was performed as video with audio or by telephone call. Video visits were conducted via the application Zoom due to its HIPPA compliance and its integration with the electronic medical record Epic. RESULTS: Telemedicine played a key role in our strategy to prioritize in person care for neurosurgical patients in need of urgent care while maintaining follow-ups and avoiding delays in care for other patients. During the month of April our neurosurgery department performed 315 telemedicine visits among all the different subspecialties. 172 (55%) were phone consults, 143 (45%) video consults; 101 (32%) were new consults, 195 (62%) return visits, 18 (6) post-operative follow-ups. New consults were mainly carried-out as video with audio, while return visits and post-operative follow-ups were predominantly phone calls. Only 39 (12%) of this patients required surgery. CONCLUSION: We describe our experience with telemedicine in neurosurgery as an effective tool to provide care during the COVID-19 pandemic while decreasing the risk of transmission of the virus. There are still many regulatory requirements to be addressed, but telemedicine emerged from this pandemic as a valuable tool to conduct neurosurgical visits that in the future can potentially relieve the burden of travel seeking medical opinions at tertiary centers.
Telemedicine in Neurosurgery During the COVID-19 Pandemic and Beyond