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A prospective,multisite study analyzing the percentage of urological cases that can be completely managed by telemedicine
Authors:Bruno Turcotte,Sophie Paquet,Anne-Sophie Blais,Annie-Claude Blouin,Sté  phane Bolduc,Michel Bureau,Yves Caumartin,Jonathan Cloutier,Marie-Pier Deschê  nes-Rompré  ,Thierry Dujardin,Yves Fradet,Louis Lacombe,Katherine Moore,Fannie Morin,Geneviè  ve Nadeau,David Simonyan,Fré    ric Soucy,Rabi Tiguert,Paul Toren,Michele Lodde,Fré    ric Pouliot
Affiliation:1.Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada; 2.Clinical and Evaluative Research Platform, Research Centre, CHU de Québec-Université Laval, Quebec City, QC, Canada
Abstract:IntroductionThe COVID-19 pandemic has accelerated the development of telemedicine due to confinement measures. However, the percentage of outpatient urological cases that could be managed completely by telemedicine outside of the COVID-19 pandemic remains to be determined. We conducted a prospective, multisite study involving all urologists working in the region of Quebec City.MethodsDuring the first four weeks of the regional confinement, 18 pediatric and adult urologists were asked to determine, after each telemedicine appointment, if it translated into a complete (CCM), incomplete (ICM), or suboptimal case management (SCM, adequate only in the context of the pandemic).ResultsA total of 1679 appointments representing all urological areas were registered. Overall, 67.6% (95% confidence interval [CI] 65.3; 69.8), 27.1% (25.0; 29.3), and 4.3% (3.5; 5.4) were reported as CCM, SCM, and ICM, respectively. The CCM ratio varied according to the reason for consultation, with cancer suspicion (52.9% [42.9; 62.8]) and pediatric reasons (38.0% [30.0; 46.6]) showing the lowest CCM percentages. CCM percentages also varied significantly based on the setting where it was performed, ranging from 61.1% (private clinic) to 86.8% (endourology and general hospital).ConclusionsWe show that two-thirds of all urological outpatient cases could be completely managed by telemedicine outside of the pandemic. After the pandemic, it will be important to incorporate telemedicine as an alternative for a patient’s first or followup visit, especially those with geographical, pathological, and socioeconomic considerations.
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