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2.
Ann R Coll Surg Engl ; 103(8): 599-603, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1910438

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has demanded radical changes in service delivery. Our centre adopted the use of outpatient telemedicine to reduce close-contact interactions between patients and staff. We hypothesised that incidental gains may be associated with this. We evaluated financial, practical and environmental implications of substituting virtual clinics (VCs) for in-person urology outpatient appointments. METHODS: VCs were studied over a 3-month period. Based on patient-reported 'usual mode of transport' to the hospital, travel distance, time, petrol and parking costs, and the carbon emissions avoided by virtue of remote consultations were calculated. The underlying symptom/diagnosis and the 'effectiveness' of the VC were evaluated. RESULTS: Of 1,016 scheduled consultations, 736 (72.44%) were conducted by VCs over the study period. VCs resulted in an agreed treatment plan in 98.4% of a representative patient sample. The use of VCs was associated with an overall travel distance saving for patients of 31,038 miles (49,951km) over 3 months, with an average round-trip journey of 93.8 miles (151km) avoided for each rural-dwelling patient and an average financial saving of £25.91 (€28.70) per rural-dwelling car traveller. An estimated 1,257.8 hours of patient time were saved by avoidance of travel and clinic waiting times. Based on car-travelling patients alone, a 6.07-tonne reduction in carbon emissions was achieved with the use of VCs. CONCLUSIONS: In appropriate clinical circumstances, VCs appear to provide efficiency across a number of domains. Future healthcare may involve offering outpatients the option of telemedicine as an alternative to physical attendance.


Subject(s)
Cost Savings , Remote Consultation , Travel , Vehicle Emissions , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Female , Humans , Male , Middle Aged , United Kingdom , Urology , Young Adult
3.
European Urology Open Science ; 20:S21, 2020.
Article in English | EMBASE | ID: covidwho-1108859

ABSTRACT

Introduction: Ireland has the one of the lowest urologist per population ratios in Europe1. Out-patient department (OPD) visits are time consuming, costly and frequently patients cannot be reviewed in the intended timeframe2. With the COVID-19 crisis innovative virtual models of care are essential. Methods: Patients for OPD review were assessed by a Consultant in a “virtual” clinic using electronic records (letters, imaging, blood results) and chart review if required. Patients were either discharged, discharged for GP testing with specified re-referral criteria, phone/letter follow up by a LUTS clinical nurse specialist, investigated and reviewed by phone/letter, or returned for face-to-face consultation. Results: 400 patients were assessed. The majority were seen previously by SHO or junior registrar. 160 (40%) patients were discharged directly via letter and advice. 121 (30%) required further imaging and could be contacted by phone with the results. 79 (20%) could be contacted by the LUTS clinical nurse specialist for phone/written review. 40 (10%) necessitated face-to-face OPD review for clinical assessment or investigation review. In 47 patients there was insufficient information available in the electronic platforms, thus requiring formal chart review. Overall, 360 patients could be managed via “virtual” means. The potential out-patient cost savings were estimated at €27,000. Conclusion: With this COVID-19 pandemic, innovative models of care are necessitated. Introduction of a “virtual” OPD clinic allows reliable review of patients with reduced face-to-face follow-up attendances. Further study of staff training and patient satisfaction is required.

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