The Feasibility and Acceptability of Utilizing Telehealth for Increasing Access to Bariatric Surgery

Bariatric surgery is recommended as the most efficacious treatment for patients living with obesity (body mass index [BMI; kg/m2] > 40; or BMI 35-39.9 with related medical conditions). Adoption of telehealth services offers an opportunity to reduce barriers and expand access to high quality specialty care for patients considering bariatric surgery for treatment of obesity. Two important advances in telehealth services occurred during the COVID-19 public health emergency. Specifically, the patient's home is now the origin site for all services where patients are no longer required to travel to a designated telehealth location, and the use of telehealth has expanded to multidisciplinary health care teams. Our bariatric surgery care team has gained valuable experience using a combination of face-to-face (F2F) and telehealth visits for multidisciplinary evaluation in preparation for bariatric surgery since March 2020. Appointments that do not require a physical exam like nutrition, psychology, group education, and medical visits after completion of pre-operative testing are particularly amenable to telehealth services. Increased use of telehealth has the potential to reduce barriers to care (e.g., lack of access to accredited bariatric surgery treatment centers, extended travel time for multiple pre-surgery appointments), increase adherence to required program visits, and increase patient satisfaction. Patient satisfaction variables may include reduced time away from work, flexibility in appointment scheduling, and reduced physical demands of multiple F2F visits. A necessary first step is to demonstrate that the protocol outlined below can be successfully implemented in a real-world clinical setting and is deemed acceptable by patients preparing for bariatric surgery.

Inclusion Criteria:Meet medical necessity criteria for primary bariatric surgery and reside in FL, (2) can participate fully in all aspects of the protocol and keep scheduled appointments, (3) have in home access to telehealth (4) provide written informed consent, (5) are willing to accept randomization, and (6) have a primary care doctor to facilitate local testing in preparation for bariatric surgery.Exclusion Criteria: