Telemedicine in orthopedics

Orthopedics is a hands-on specialty requiring direct physical contact between the practitioner and the patient. This is true in all orthopedic settings, including outpatients, surgery, trauma and emergency, and rehabilitation. It is not surprising therefore that telemedicine applications in the field of orthopedics have lagged behind other medical specialties such as pathology and radiology, which are readily amenable to remote delivery via technology. Despite these challenges, steady progress has been made to overcome the many technological and practical barriers. This work is driven by the many potential benefits of telemedicine applications such as improving access to services; optimizing the timing, intensity, and sequencing of intervention; and reducing the costs and time associated with traveling to health services [1]. Telemedicine applications in orthopedics cover a wide range of services, including diagnostics, remote monitoring of progress, education for patients and their care providers, clinical training, and therapeutic intervention. This chapter will outline the state of the art of telemedicine practice and research in the four main orthopedic settings: outpatient orthopedics, trauma and emergency orthopedics, surgery, and rehabilitation (Figure 20.1). For each of these settings we present relevant research that has described and/or evaluated how telemedicine has been used, provided an overview of the range of telemedicine technologies that have been used, reported the main findings of these studies, and highlighted where further research is needed. [Chapter Introduction]