Good Comes From Evil: COVID-19 and the Advent of Telemedicine in Orthopedics
The consequences of the COVID-19 pandemic continue to affect many facets of our lives. One consequence has been the integration of web-based videoconferencing platforms into both the professional and personal lives of many people worldwide. Social distancing mandates, implemented to prevent the spread of the virus, prompted many health care institutions to transition rapidly from in-person to remote patient encounters via various telehealth platforms for most clinical care episodes [21,42]. This collective pivot to telehealth was important for musculoskeletal care providers including orthopedic surgeons, primary care physicians, physiatrists, and physical and occupational therapists; it allowed them to care for patients with conditions deemed non-essential for in-person consultation but still warranting evaluation and treatment [21,42]. Furthermore, it provided a safer alternative in caring for patients who are at high risk for complications related to SARS-CoV-2 infection, including patients older than 65 years and those with certain comorbidities . Although the utilization of telemedicine had increased over the past few decades within certain medical disciplines, including primary care medicine, radiology, and dermatology, it had not been widely implemented among musculoskeletal care providers [11,13,52,66]. Barriers to implementation have included doubts that a reliable physical examination could be performed and a lack of experience and comfort in providing patient care via videoconferencing platforms. Other concerns that have prevented the widespread adoption of telemedicine include a lack of reimbursement from multiple payers including the Centers for Medicare and Medicaid Services (CMS), legal concerns regarding medical licensure law and personal health information (PHI) protection, and socioeconomic barriers .