MP31-15: Teleurology: Expanding Horizons to Inpatient eConsults

Nathan Feiertag*, Benjamin Green, Justin Loloi, Brendon Hopgood, Farzaan Kassam, Olsjon Shperdheja, Priya Dave, Jubin Matloubieh, Jennifer Nauheim, Mustufa Babar, Max Abramson, Alex Sankin, Nitya Abraham, Ahmed Aboumohamed, Alexander Small, Jillian Donnelly, Frank Lowe, Melissa Laudano, Kara Watts, Bronx, NY

Introduction: Telemedicine use rapidly increased during the COVID-19 pandemic. However, the efficacy of telemedicine in the inpatient setting has yet to be addressed. To this end, we measured patient and provider satisfaction with video and face-to-face (FTF) consults for inpatient urology consultations and sought to identify the urologic conditions most suitable for video consults.

Methods: New inpatient urology consults between August 2021 - October 2021 were randomized to either video or FTF consult. Patient surveys were administered within 24 hours to assess satisfaction and perceived quality of care during the consult (3-point ordinal Likert scale). Survey results were analyzed using Mann-Whitney U tests. Participating urology attendings completed a survey assessing satisfaction and utility of both consultation mediums (3-point ordinal Likert scale), and suitability of video consults for common urologic consultation conditions (5-point ordinal Likert scale).

Results: A total of 48 patients were included; 23 (48%) received video consult and 25 (52%) FTF consults. There were no significant differences in age or race between the cohorts. The most common reasons for consultation were acute urinary retention (Video: 5 [22%], FTF: 5 [20%]) and urolithiasis (Video: 5 [25%], FTF: 3 [12%]). Both cohorts agreed that they were overall satisfied with their visit (Video: 22 [95.7%], FTF: 25 [100%]; p = 0.297), received high-quality care (Video: 22 [95.7%], FTF: 23 [92.0%]; p = 0.61), and would accept the visit modality again in the future (Video: 21 [91.3%], FTF: 25 [100%]; p = 0.14). Urologists agreed on the utility of both consultation mediums, including ability to gather complete information (Video: 7 [100%], FTF: 7 [100%]) and manage the patient (Video: 6 [85.7%], FTF: 7 [100%]; p = 0.71). Physician satisfaction was lower for video consult than FTF (Video: 5 [71.4%], FTF: 7 [100%]; p = 0.38), and physicians were less likely to agree that video consults were satisfactory compared to FTF visits (4 [57.1%]). The most suitable urologic conditions for video consultation were elevated PSA and urinary retention (4.85 ± 0.38), followed by urinary incontinence and nephrolithiasis (4.71 ± 0.49). The least suitable was scrotal wall swelling (2.71 ± 0.76).

Conclusions: With increasing telemedicine utilization, video consults offer an alternative to FTF rounding that may combat difficulties of urologist shortages. Video consults enable urologists to see a wide variety of inpatient consults without hindering patient satisfaction. However, adoption of this tool will rely on physician preference and competence with video technology.

Source of Funding: None.