PREOPERATIVE HISTORY AND PHYSICAL UPDATE VISITS OFFER LIMITED CLINICAL VALUE IN COLORECTAL SURGERY.

Background: United States regulations require a history and physical (H&P) <= 30 days before planned procedures. We evaluated the impact of H&P update visits in colorectal surgery. Methods: Preoperative H&P update visits conducted in colorectal clinics at our institution during 2019 were identified. Two independent reviewers assessed whether update visits identified interval changes to history, exam, or operative plan. Secondary outcomes included visit times, estimated travel times and distances. Results: For 132 visits, interval changes were identified in 39% of histories, but only 4.2% of exams and 6.8% of operative plans. When plans changed, visit goals could have been accomplished via telehealth in 77.8%. Median clinic and round-trip driving time were 61.5 and 62.2 min, respectively. Conclusions: H&P update visits conducted to satisfy the 30-day regulation rarely result in clinically relevant changes yet impose time and travel burdens on patients. Regulations should be revised to provide flexibility in H&P update modalities.