P079 Use of an electronic text messaging service to improve efficiency in initial Fracture Liaison Service Patient Assessment

Abstract

Abstract Background/Aims Fracture Liaison Service (FLS) is labour intensive. It aims to identify all patients aged over 50 years presenting with a new fragility fracture and assess for treatment, in order to prevent future fractures and associated morbidity and mortality. According to the Royal Osteoporosis Society published Standards (2015), patients should have a comprehensive bone assessment within 3 months of the incident fracture. However, such assessments are time consuming, typically taking up to 40 minutes of an FLS practitioner's time. Understaffing led to designing an approach to gather information and streamline the Fracture Liaison service. Methods We approached an electronics communication company who generated a secure form containing the information required for FLS initial assessment. As a trial, all patients identified by the FLS as having a new fragility fracture between 15th November 2021 and 15th December 2021 were sent a text link to this questionnaire. A follow-up message was sent 1 day and 1 week later (3 messages in total). The questionnaires were then exported to the patient's electronic clinical record. Data collected included information allowing prediction of risk for future fractures. Following assessment of this data, action letters could be sent to the GP advising on a treatment plan, for example, to start an oral bisphosphonate or referral for parenteral treatment. We analysed the results and performed cost analysis based on comparison to normal practice where the initial assessment would have been undertaken as a clinic appointment. Results 43 out of 103 patients (42%) responded to the questionnaire. Of these 43 patients, 32 (74%) were female and the majority aged 60 to 79 years. Our cost analysis showed that allowing for a 30-minute face to face appointment for each of 43 patients would have taken 22.5 hours. By comparison, virtual assessment of the data from each questionnaire took only 8 minutes ie a total of 5.7 hours. This saved 16.8 hours of the FLS practitioner's time with a calculated cost saving of £352, based on professional time cost of £21 per hour. Face to face attendances would have cost £120 per patient ie £5160 for 43 patients. The total amount saved using the electronic questionnaire for 43 patients was £5512. Conclusion We were able to capture the initial FLS bone assessment data using an electronic questionnaire in 43 out of 103 patents. This resulted in a significant cost saving from outpatient clinics of £5512 over a 1-month period. Downstream processing of the data was much shorter. Further action will be to modify the text messages to increase yield of patients. Electronic fracture liaison is effective at reducing demands on the service and coordinating activity. We have demonstrated a significant cost saving on a small number of patients. Disclosure R. Reid: None. E. Lever: None. D. Davis: None.