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一项由临床医生主导的虚拟泌尿外科诊所的前瞻性临床、成本及环境分析。

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

作者信息

Miah S, Dunford C, Edison M, Eldred-Evans D, Gan C, Shah T T, Lunn P, Winkler M, Ahmed H U, Gibbons N, Hrouda D

机构信息

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

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

出版信息

Ann R Coll Surg Engl. 2019 Jan;101(1):30-34. doi: 10.1308/rcsann.2018.0151. Epub 2018 Oct 5.

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 CO, depending on mode of transport. Our predicted 12-month avoided carbon footprint is 1.04-4.04 metric tonnes of CO.

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.

摘要

引言

虚拟诊所是远程医疗的一种形式,临床团队与患者之间无需面对面咨询即可进行接触。我们的研究旨在量化我们虚拟泌尿外科诊所的临床、财务和环境效益。

材料与方法

我们前瞻性地收集了2017年7月至9月连续四个月每周随访虚拟诊所的数据。

结果

我们共审查了409例患者。经过虚拟诊所咨询后,68.5%的患者无需进一步随访。我们的大多数患者(男性57.7%,女性55.5%)处于工作年龄。满意度得分很高,为90.1%,且没有报告因使用虚拟诊所而出现不良事件。我们计算出的成本节约为18,744英镑,预计12个月的成本节约为56,232英镑。额外面对面诊所容量的增加预计为我们科室带来12个月的72,072英镑的诊疗费增长。使用虚拟诊所的患者总共避免了4623英里的行程,根据交通方式的不同,估计避免的碳足迹为0.35 - 1.45公吨二氧化碳。我们预计12个月避免的碳足迹为1.04 - 4.04公吨二氧化碳。

结论

我们的虚拟诊所模式已展现出临床、财务和环境效益三方面的积极成果。在让利益相关者参与建立此类泌尿外科服务时,应将虚拟诊所的环境重要性和效益作为一种社会企业价值加以推广。我们建议在考虑采用这种远程医疗方法的泌尿外科科室采用我们的虚拟诊所模式。

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