MONDAY, Feb. 25, 2019 — Phone visits can safely substitute for a standard, in-person history and physical (H&P) in patients undergoing cataract surgery, according to a study published online Feb. 7 in the Journal of General Internal Medicine.
Manju L. Subramanian, M.D., from the Boston University School of Medicine, and colleagues retrospectively compared outcomes before and after implementation of an initiative in which patient history and preoperative instructions were conducted by phone instead of in person for patients undergoing cataract surgery. A total of 2,055 patients had phone visits, and 2,911 had standard H&Ps.
In the 30 days after surgery, the researchers found no unplanned admissions or mortalities in either group. Compared with standard H&Ps, noncompliance rates for phone visits were significantly lower (21 versus 13 percent). Similarly, same-day surgery cancellations were significantly lower two years after initiation of phone histories. The phone interviews took less time (15 versus 45 minutes for a standard H&P), freeing up an estimated 27 hours/week and allowing medical clearance for three times as many patients.
“Based on our results, we believe the universal application of independent and complete in-person H&Ps for patients undergoing cataract surgery is not medically necessary for most patients, represents low-value care, and increases visit burden,” the authors write.
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Posted: February 2019
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