Abstract
Background There is great interest in non face to face (F2F), internet or app based outpatient interact at the moment. As these become established, we look at the non F2F appointments already happening in telephone and virtual clinics in a busy urban rheumatology department. Here we look at the type of diagnoses dealt with in a non F2F environment and potential outcomes from these non F2F appointments. Objectives To assess the efficiency and utilisation of virtual and telephone clinics in a general rheumatology department. Methods Data was collected from electronic (Cerner) patient records on 240 patients who had a virtual appointment in May 2018. The data was analysed using Excel 2010. Results 240 patients had virtual appointments in one month. 121 (50.4%) were via telephone and 119 (49.6%) via patient letter. 34 (14.1%) patients had multiple virtual/telephone appointments. 129 (54%) were carried out by consultants, 78 (32%) by nurses and 33 (14%) by registrars. 37% had rheumatoid arthritis. 32 (13%) appointments lead to a prescription. Virtual appointments produced 44 referrals, including 18 to another specialty, 16 to physiotherapy, and the rest to hand therapy or podiatry. Most patients had a F2F appointment before and after their virtual appointment in May 2018, 1 patient had died before having a second face to face appointment and 13 (5%) were discharged from their virtual appointment. Conclusion Consultants undertook the bulk of virtual clinics, and these appointments resulted in the majority of referrals and prescriptions. Virtual appointments reduce the waiting times for contact with a healthcare professional between appointments. Many patients had several virtual appointments between face to face appointments and this cohort may benefit from more scrutiny. Current technology already imporves communication and leads to significant changes in patient care without requiring F2F appointments. Internet based and app based interaction should face the same scrutiny. Disclosure of Interests None declared
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