Provider confidence in the telemedicine spine evaluation: results from a global study

Francis Lovecchio, Grant J. Riew, Dino Samartzis, Philip K. Louie, Niccole Germscheid, Howard S. An, Jason Pui Yin Cheung, Norman Chutkan, Gary Michael Mallow, Marko H. Neva, Frank M. Phillips, Daniel M. Sciubba, Mohammad El-Sharkawi, Marcelo Valacco, Michael H. McCarthy, Melvin C. Makhni, Sravisht Iyer

Research output: Contribution to journalArticlepeer-review


Purpose: To utilize data from a global spine surgeon survey to elucidate (1) overall confidence in the telemedicine evaluation and (2) determinants of provider confidence. Methods: Members of AO Spine International were sent a survey encompassing participant’s experience with, perception of, and comparison of telemedicine to in-person visits. The survey was designed through a Delphi approach, with four rounds of question review by the multi-disciplinary authors. Data were stratified by provider age, experience, telemedicine platform, trust in telemedicine, and specialty. Results: Four hundred and eighty-five surgeons participated in the survey. The global effort included respondents from Africa (19.9%), Asia Pacific (19.7%), Europe (24.3%), North America (9.4%), and South America (26.6%). Providers felt that physical exam-based tasks (e.g., provocative testing, assessing neurologic deficits/myelopathy, etc.) were inferior to in-person exams, while communication-based aspects (e.g., history taking, imaging review, etc.) were equivalent. Participants who performed greater than 50 visits were more likely to believe telemedicine was at least equivalent to in-person visits in the ability to make an accurate diagnosis (OR 2.37, 95% C.I. 1.03–5.43). Compared to in-person encounters, video (versus phone only) visits were associated with increased confidence in the ability of telemedicine to formulate and communicate a treatment plan (OR 3.88, 95% C.I. 1.71–8.84). Conclusion: Spine surgeons are confident in the ability of telemedicine to communicate with patients, but are concerned about its capacity to accurately make physical exam-based diagnoses. Future research should concentrate on standardizing the remote examination and the development of appropriate use criteria in order to increase provider confidence in telemedicine technology.

Original languageEnglish (US)
Pages (from-to)2109-2123
Number of pages15
JournalEuropean Spine Journal
Issue number8
StatePublished - Aug 2021


  • Examination
  • International
  • Spine surgery
  • Survey
  • Telemedicine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


Dive into the research topics of 'Provider confidence in the telemedicine spine evaluation: results from a global study'. Together they form a unique fingerprint.

Cite this