A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic

Author:

Miah S123,Dunford C13,Edison M1,Eldred-Evans D4,Gan C1,Shah TT14,Lunn P1,Winkler M1,Ahmed HU14,Gibbons N1,Hrouda D1

Affiliation:

1. Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK

2. Division of Surgery and Interventional Science, University College London, London, UK

3. Both are first joint authors

4. Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK

Abstract

Introduction A virtual clinic is a form of telemedicine where contact between clinical teams and patients occur without face-to-face consultation. Our study aims to quantify the clinical, financial and environmental benefits of our virtual urology clinic. Material and methods We collected data prospectively from our weekly follow-up virtual clinic over a continuous four-month period between July and September 2017. Results In total, we reviewed 409 patients. Following virtual clinic consultation, 68.5% of our patients were discharged from further follow-up. The majority of our patients (male 57.7%, female 55.5%) were of working age. The satisfaction scores were high, at 90.1%, and there were no reported adverse events as a result of using the virtual clinic. Our calculated cost savings were £18,744, with a predicted 12-month cost saving of £56,232. The creation of additional face-to-face clinic capacity has created an estimated 12-month increase in tariff generation for our unit of £72,072. In total, 4623 travel miles were avoided by patients using the virtual clinic, with an estimated avoided carbon footprint of 0.35–1.45 metric tonnes of CO2e, depending on mode of transport. Our predicted 12-month avoided carbon footprint is 1.04–4.04 metric tonnes of CO2e. Conclusions Our virtual clinic model has demonstrated a trifecta of positive outcomes, namely, clinical, financial and environmental benefits. The environmental importance and benefits of a virtual clinic should be promoted as a social enterprise value when engaging stakeholders in setting up such a urological service. We propose the adoption of our virtual clinic model in those urological units considering this method of telemedicine.

Publisher

Royal College of Surgeons of England

Subject

General Medicine,Surgery

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