A significant proportion of patient transfers in Ontario are from long-term care facilities for consultation of musculoskeletal (MSK) issues. These transfers are costly for patients and the healthcare system. This study evaluated the utility of a Telemedicine MSK (TeleMSK) service for long-term care patients requiring an orthopaedic consultation. A cross-sectional study was used to assess TeleMSK from September 2018 to April 2019. 26 long-term care facilities participated in this study, which included 32 long-term care patients assessed via TeleMSK and 27 telemedicine liaisons. Telemedicine Satisfaction Scale (TeSS) and the Telemedicine Usability Questionnaire (TUQ) surveys were used to evaluate the usefulness of the TeleMSK program. Patients and families rated voice (64.3%) and visual (71.4%) quality of TeleMSK to be excellent as well as the length of consultation (92.9%). 78.6% participants rated explanations from physicians to be excellent, 92.9% of the participants rated the carefulness, skillfulness, respect, and sensitivity of the attending physician to be excellent (85.7%). Patients felt privacy and confidentiality was maintained and respected throughout the consultation. The majority of telemedicine liaisons agreed that TeleMSK improved accessibility and productivity of consultations and 81.5% of the telemedicine liaisons strongly agreed that they would use TeleMSK again in the future. TeleMSK allowed for accessible, timely orthopaedic consultations without compromising the quality of patient care. Patients, families, and telemedicine liaisons rated their experience and use of TeleMSK as excellent. Barriers to healthcare are important issues to be addressed in the long term care population. This can be conducted efficiently and effectively with Telemedicine.
In a previously published multicenter randomized clinical trial it was shown that young patients (16–60 years-old) with displaced mid-shaft clavicle fractures had superior limb specific outcomes when they were treated with primary plate fixation versus non operative treatment at one year follow-up. This study examines the general health status of this cohort of patients at two-years post injury. We evaluated the general health of a cohort of patients with displaced mid-shaft clavicle fractures comparing non-operative versus plate fixation at two-years after injury. At the conclusion of our study, eighty-nine patients (fifty-four from the operative group and thirty-five from the non-operative group) completed the two-year follow-up. Outcome analysis included the standard clinical follow-up and SF-36 scores.Purpose
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