Department of Surgery, Raigmore Hospital, Inverness, UK.
Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK.
Colorectal Dis. 2020 Sep;22(9):1015-1021. doi: 10.1111/codi.15239. Epub 2020 Jul 31.
For patients, an outpatient review can lead to a stressful journey to hospital with the resultant risks associated with breaching social distancing. Despite this, video consultations (VCs) have not been frequently used in colorectal practice. We assessed outcomes, including the economic and environmental impact, of a VC clinic for new colorectal referrals.
This was a prospective observational study. Fifty consecutive patients attending a VC colorectal appointment were reviewed between March 2019 and February 2020. Face-to-face appointments during the same time period were also assessed. The distance, time, cost and carbon emissions of journeys were estimated using web-based resources. Estimated loss of earnings used data from the Office for National Statistics. The subsequent management plans were also recorded.
Of 50 patients using VC, 40 used home devices and 10 used equipment in their local medical facility. Three patients had difficulties with the technology and converted to telephone review. Failure to attend VC appointments was less than for face-to-face appointments (4% vs 6.1%). VC appointments saved 6685 miles of travel (range 2-364 miles), 148 h travelling time and £1767 costs. Additional savings for loss of earnings were approximately £33.56 per patient. The carbon emissions saved was 4659 lb CO equivalent, corresponding to over 250 000 charges of a smartphone.
The use of VC resulted in significant savings related to travel and reduced time and costs for patients who chose to use the service, in addition to the environmental benefits. In this current climate VC clinics have a central role in outpatient care for both new patients and follow-ups.
对于患者而言，门诊复查可能会导致他们前往医院的旅程变得紧张不安，从而增加违反社交距离规定的风险。尽管如此，视频咨询（VC）在结直肠实践中并未得到广泛应用。我们评估了新结直肠转诊患者的 VC 诊所的结果，包括经济和环境影响。
这是一项前瞻性观察研究。在 2019 年 3 月至 2020 年 2 月期间，对 50 名参加 VC 结直肠预约的连续患者进行了回顾。同时还评估了同期的面对面预约。使用基于网络的资源估计了旅程的距离、时间、成本和碳排放。使用来自国家统计局的数据估计了收入损失。还记录了随后的管理计划。
在 50 名使用 VC 的患者中，有 40 名使用家庭设备，10 名在当地医疗设施中使用设备。有 3 名患者在技术方面遇到困难，转为电话复查。VC 预约的未出席率低于面对面预约（4%对 6.1%）。VC 预约节省了 6685 英里的旅行（范围 2-364 英里）、148 小时的旅行时间和 1767 英镑的费用。因缺勤而节省的收入约为每位患者 33.56 英镑。节省的碳排放量为 4659 磅二氧化碳当量，相当于超过 250000 次智能手机充电。
使用 VC 可显著节省与旅行相关的费用，并减少选择使用该服务的患者的旅行时间和成本，此外还具有环境效益。在当前环境下，VC 诊所在新患者和随访患者的门诊护理中发挥着核心作用。
