Teleconsultation versus traditional clinical assessment of patients undergoing circumcision: A retrospective cohort study

Abstract

Objective: To determine whether standalone teleconsultation is an effective alternative to face-to-face assessment of patients requiring circumcision. To determine what environmental and efficiency benefits may arise as a result of service alteration. Patients and Methods: All cases listed for circumcision during first UK lockdown (1 February to 30 September 2020) were reviewed. Cases were collated from operative lists, theatre logs and secretarial records. Cancellations and rationale were recorded. Local audit approval was granted for conduct of this study. Statistical analysis was conducted in JASP. Results: A total of 101 patients were listed for circumcision during the study period. The overall odds of cancellation was 0.063. There was no significant difference in odds of cancellation between telephone clinic and face-to-face clinic odds ratio 0.371 (confidence interval (CI): 0.039–3.46). Telephone clinic could achieve a per-patient cost reduction of £81 and a total reduction in CO2 emissions of 637 kg. Discussion: This is the first study to demonstrate teleconsultation as a suitable method to list patients for circumcision without a face-to-face appointment. The COVID pandemic has accelerated transformational change in outpatient service design instigated by the National Health Service (NHS) Long-Term plan. The environmental and efficiency savings demonstrated suggest sustainable change beyond the pandemic. Level of Evidence: Level 3 (cohort study)