Online video consultations rapidly gained ground during the COVID-19 pandemic, reshaping patient care delivery across multiple specialities. While their feasibility in routine follow-up appointments is well recognised, their effectiveness in complex, high-stakes settings such as preoperative consultations remained uncertain. The VIDEOGO trial, a multicentre, randomised, controlled, non-inferiority study conducted in the Netherlands, explored whether video consultations were comparable to face-to-face meetings when preparing patients for major abdominal surgery. The study assessed patient satisfaction and information recall as primary outcomes, alongside secondary measures such as surgeon satisfaction, time efficiency, financial costs and environmental impact.
Patient Satisfaction and Recall Remain Stable
The VIDEOGO trial included 112 patients who were randomly assigned to receive either an online video or a face-to-face consultation prior to major abdominal surgery. Patient satisfaction, rated on a 100-point scale, was nearly identical across both groups: 85.4 for online consultations and 85.2 for in-person meetings. This consistency extended to subgroups, including older patients and those with lower levels of health or digital literacy, suggesting that online formats are broadly acceptable. Information recall, tested through a custom nine-item questionnaire, also showed no meaningful differences, with both groups scoring around 7.3 out of 11. These findings indicate that video consultations do not compromise the quality of communication, even in complex clinical scenarios requiring the explanation of procedures, risks and recovery expectations.
Efficiency Gains and Environmental Benefits
Online consultations offered significant benefits in time saved, reduced financial burden and a lower environmental impact. Patients attending online appointments avoided travel altogether, compared with a median round-trip distance of nearly 68 km for those seen in person. This led to a substantial reduction in carbon emissions, with online sessions producing an average of 93 grams of CO₂ equivalent per consultation, compared with 7783 grams for face-to-face visits. In terms of cost, the average online consultation cost €0.01, primarily for electricity, while in-person visits cost a median of €17.90, largely due to travel and parking expenses. The online group also benefited from shorter start-up and waiting times. Preparation time for online appointments was a median of five minutes, compared with 120 minutes of travel time for face-to-face visits. Waiting times were also lower, with patients spending ten minutes in a virtual waiting room versus 15 minutes in hospital.
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These gains are particularly important as healthcare systems seek to reduce their environmental footprint and improve access to services, especially for patients who live at a distance from specialist centres. The evidence suggests that video consultations can contribute meaningfully to these goals without sacrificing patient satisfaction or understanding.
Clinical Acceptance and Practical Considerations
Surgeons generally reported similar satisfaction levels for both types of consultation. The only notable difference was a perceived lower involvement of patients’ relatives in online sessions. This may reflect unfamiliarity with the platform or limitations in early-stage implementation. However, most video systems now support multi-user access, making it possible for relatives to join the conversation from remote locations. Among patients and surgeons who used the video format, a strong majority indicated they would recommend it to others. Importantly, no patients requested an additional face-to-face consultation for clarification, and no one refused surgery following an online consultation.
Only two minor technical issues were reported among video consultations: one involving the video connection and another involving audio. Both were resolved during the session without interrupting the consultation. This suggests that with appropriate support, online consultations can be reliably integrated into clinical workflows. At the study sites, support teams helped patients navigate the necessary technology, improving the overall experience and uptake.
Although nearly 30% of screened patients were ineligible due to technological or personal limitations, the findings still support the use of video consultations as an additional option rather than a replacement for in-person visits. Patient preference remains an important element of care quality. For those who are digitally literate and comfortable with online communication, the video format offers a valuable alternative.
The VIDEOGO trial demonstrates that online video consultations for major abdominal surgery are not only non-inferior to face-to-face meetings in terms of patient satisfaction and information retention, but also provide notable advantages in efficiency, cost and environmental impact. While in-person consultations remain essential for patients requiring physical examination or those less comfortable with digital platforms, video consultations represent a viable and often preferable alternative. With the increasing adaptation of health systems to increased centralisation, ageing populations and sustainability imperatives, integrating online consultations into routine care pathways can help meet future demands without compromising quality. Thoughtful implementation, technical support and flexible policies will be key to realising their full potential.
Source: The Lancet Digital Health
Image Credit: iStock
