WVU Medicine orthopaedic hand, elbow, and shoulder surgeon Rd. Shafic Sraj offers patients undergoing office-based surgery the convenience of virtual post-operative care through MyWVUChart, WVU Medicine’s online patient portal.
Sraj saw adopting an app-based follow-up process as the natural progression to the wide-awake local anesthesia no tourniquet, WALANT, procedures performed in the office setting. Patients who are comfortable using the app are offered the option to use its secure messaging feature for their follow up after routine, low-risk procedures.
“We developed a standard, automated questionnaire with all the information that would be asked in a traditional office visit,” Sraj said. “It allows patients to provide detailed and meaningful responses and photos so that I can assess how they are healing.”
The questionnaire was a collaborative effort between Sraj and Lauren Latsnic, coordinator of telemedicine, and allows asynchronous two-way communication.
“We were able to create a tool specifically for his needs,” Latsnic said.
“Patients do not have to be at the mercy of their connection anymore, which can be unreliable in some areas. Instead of getting a telemedicine appointment and wait to see me on their device, they just respond to the automated questionnaire, attach a photo of the incision, and send it away,” Sraj said. “The photos allow me to check if things are progressing normally or if there is anything that needs to be addressed.”
Having a virtual option for post-operative care can be more than a matter of convenience. Sraj’s patient Alyssa Field said knowing she would not need to make additional schedule changes to accommodate post-operative appointments motivated her to finally schedule her surgery.
As an operating room technician at WVU Medicine J.W. Ruby Memorial Hospital and matriarch within her family, she did not want schedule changes to negatively impact those around her. However, delaying treatment not only increased her pain but also the severity of injury to her finger.
“I waited until I just couldn’t take the pain anymore,” she said.
Dr. Nancy McKinley, an orthopaedic surgeon who had no prior experience with WALANT procedure or virtual post-operative care, cited schedule disruption and caution for this approach to care as cause for delayed treatment.
“I had concerns that things could ‘slip through the cracks’ with the reliance on MyChart for follow-up care,” she said. “In the end, I had absolutely no qualms.”
Her experience was convenient, and she also found the process to be unexpectedly empowering.
“I felt it reinforced the idea of me as a participating member of the healthcare team,” McKinley said. “I actually felt as though communication was enhanced and facilitated.”
Patients are encouraged and enabled to communicate concerns throughout the entire process; something that Field needed to do when she popped a stitch at the incision site. She was impressed with the speedy response from Sraj and his staff.
“They got me in that same day,” she said.
Ultimately, Sraj determined that the wound was not compromised, and Field’s recovery continued without further incident.
Field and McKinley both had surgeries to address trigger finger, but follow up using the MyWVUChart app can be an option for other procedures that are routinely done in the office, including carpal tunnel release, removal of ganglion cysts and other masses, and release of tendinitis. Surgeries that require X-rays, splinting and therapy during their follow ups still require in clinic visits.
“Switching to asynchronous visits has been a huge success and helped many patients avoid the burden or spending hours on the road for simple wound checks,” Sraj said.