Efficiency, satisfaction, and costs for remote video visits following radical prostatectomy: a randomized controlled trial

Eur Urol. 2015 Oct;68(4):729-35. doi: 10.1016/j.eururo.2015.04.002. Epub 2015 Apr 18.


Background: Telemedicine in an ambulatory surgical population remains incompletely evaluated.

Objective: To investigate patient encounters in the outpatient setting using video visit (VV) technology compared to traditional office visits (OVs).

Design, setting, and participants: From June 2013 to March 2014, 55 prescreened men with a history of prostate cancer were prospectively randomized. VVs, with the patient at home or at work, were included in the outpatient clinic calendar of urologists.

Intervention: Remote VV versus traditional OV.

Outcome measurements and statistical analysis: An equivalence analysis was used to assess the primary outcome, visit efficiency as measured by time studies. Secondary outcomes were patient/provider satisfaction and costs.

Results and limitations: There were 28 VVs and 27 OVs. VVs were equivalent in efficiency to relative to OVs, as measured by patient-provider face time (mean 14.5 vs 14.3min; p=0.96), patient wait time (18.4 vs 13.0min; p=0.20), and total time devoted to care (17.9 vs 17.8min; p=0.97). There were no significant differences in patient perception of visit confidentiality, efficiency, education quality, or overall satisfaction. VVs incurred lower costs, including distance traveled (median 0 vs 95 miles), travel time (0 vs 95min), missed work (0 vs 1 d), and money spent on travel ($0 vs $48; all p<0.0001). There was a high level of urologist satisfaction for both VVs (88%) and OVs (90%). The major limitation was sample size.

Conclusions: VV in the ambulatory postprostatectomy setting may have a future role in health care delivery models. We found equivalent efficiency, similar satisfaction, but significantly reduced patient costs for VV compared to OV. Further prospective analyses are warranted.

Patient summary: Among men with surgically treated prostate cancer, we evaluated the utility of remote video visits compared to office visits for outpatient consultation with a urologist. Video visits were associated with equivalent efficiency, similar satisfaction, and significantly lower patient costs when compared to office visits. We conclude that video visits may have a future role in health care delivery models.

Keywords: Patient acceptance; Patient perception; Randomized controlled trial; Teleconsultation; Telehealth; Telemedicine; Urology; Video visits.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ambulatory Care / economics
  • Ambulatory Care / methods*
  • Appointments and Schedules
  • Attitude of Health Personnel*
  • Cost-Benefit Analysis
  • Health Care Costs*
  • Humans
  • Male
  • Middle Aged
  • Minnesota
  • Office Visits* / economics
  • Patient Satisfaction*
  • Postoperative Care
  • Prospective Studies
  • Prostatectomy* / adverse effects
  • Prostatectomy* / economics
  • Prostatic Neoplasms / economics
  • Prostatic Neoplasms / surgery*
  • Referral and Consultation
  • Remote Consultation / economics
  • Remote Consultation / methods*
  • Time Factors
  • Time and Motion Studies
  • Videoconferencing* / economics
  • Workflow