Telemedical versus onsite treatment at an orthopaedic university clinic: Study of 280 consecutive patients.

Objective: Compare a telemedical treatment (distant working) with an onsite treatment. Telemedical services have been used frequently in non-surgical disciplines. It remains unclear if orthopaedic outpatients can be treated via telemedicine. We evaluated the diagnostic accuracy and recommended therapy of a mobile healthcare communication app. Design: We conducted a prospective, double-blind, anonymized clinical study of consecutive outpatients at an orthopaedic department at a university hospital. Patients were treated by an onsite doctor, who then uploaded each patient's variables (e.g. personal history, clinical findings, radiograph) for evaluation by a telemedical doctor. The telemedical doctor received the information only via app and did not see the patient physically. Both the onsite and telemedical doctors then uploaded their respective diagnosis and suggested therapy, blinded to each other. The patient received treatment from the onsite doctor only: virtual treatment was solely for scientific purposes and had no therapeutic impact. Results: Among 280 consecutive orthopaedic outpatients (57% female and 43% male), the mean age was 63 years. In 83% of cases, the telemedical diagnosis matched the onsite diagnosis, and in 98% of cases, the telemedical treatment did no harm. In 75% of cases, the onsite and telemedical doctors proposed the same therapy. In 2% of cases, the telemedical therapeutic regimen differed from the onsite treatment and could possibly harm the patient. Conclusion: The results suggest that diagnosis and treatment via telemedicine seems feasible in the field of orthopaedic surgery and could be an option for telemedical patient interactions (via work from home or virtual interactions).