South Warwickshire NHS Foundation Trust, UK.
University of Birmingham, UK.
Ann R Coll Surg Engl. 2023 Apr;105(4):314-322. doi: 10.1308/rcsann.2021.0364. Epub 2022 Apr 29.
The coronavirus disease 2019 (COVID-19) pandemic led to hospitals in the UK substituting face-to-face (FtF) clinics with virtual clinic (VC) appointments. We evaluated the use of virtual two-week wait (2-ww) lower gastrointestinal (LGI) clinic appointments, conducted using telephone calls at a district general hospital in England.
Patients undergoing index outpatient 2-ww LGI clinic assessment between 1 June 2019 and 31 October 2019 (FtF group) and 1 June 2020 and 31 October 2020 (VC group) were identified. Relevant data were obtained using electronic patient records. Compliance with national cancer waiting time targets was assessed. Environmental and financial impact analyses were performed.
In total, 1,531 patients were analysed (median age=70, male=852, 55.6%). Of these, 757 (49.4%) were assessed virtually via telephone; the remainder were seen FtF (=774, 50.6%). Ninety-two (6%, VC=44, FtF=48) patients had malignant pathology and 64 (4.2%) had colorectal cancer (CRC); of these, 46 (71.9%, VC=26, FtF=20) underwent treatment with curative intent. The median waiting times to index appointment, investigation and diagnosis were significantly lower following VC assessment (<0.001). The cancer detection rates (=0.749), treatments received (=0.785) and median time to index treatment for CRC patients (=0.156) were similar. A significantly higher proportion of patients were seen within two weeks of referral in the VC group (<0.001). VC appointments saved patients a total of 9,288 miles, 0.7 metric tonnes of CO emissions and £7,482.97. Taxpayers saved £80,242.00 from VCs. No formal complaints were received from patients or staff in the VC group.
Virtual 2-ww LGI clinics were effective, safe and were associated with tangible environmental and financial benefits.
2019 年冠状病毒病（COVID-19）大流行导致英国的医院将面对面（FtF）诊所改为虚拟诊所（VC）预约。我们评估了在英格兰的一家地区综合医院使用电话进行的虚拟两周等待（2-ww）下消化道（LGI）诊所预约的情况。
我们确定了在 2019 年 6 月 1 日至 10 月 31 日（FtF 组）和 2020 年 6 月 1 日至 10 月 31 日（VC 组）期间接受门诊 2-ww LGI 诊所评估的指数患者。使用电子病历获得了相关数据。评估了符合国家癌症等待时间目标的情况。进行了环境和财务影响分析。
共分析了 1531 例患者（中位数年龄=70，男性=852，55.6％）。其中，757 例（49.4％）通过电话进行了虚拟评估；其余的则 FtF 就诊（774，50.6％）。92 例（6％，VC=44，FtF=48）患者存在恶性病理学，64 例（4.2％）患有结直肠癌（CRC）；其中，46 例（71.9％，VC=26，FtF=20）接受了根治性治疗。VC 评估后，指数就诊、检查和诊断的中位等待时间明显缩短（<0.001）。癌症检出率（=0.749）、接受的治疗（=0.785）和 CRC 患者指数治疗的中位时间（=0.156）相似。VC 组中在两周内就诊的患者比例明显更高（<0.001）。VC 预约为患者总共节省了 9288 英里，0.7 公吨的 CO 排放量和 7482.97 英镑。纳税人从 VC 中节省了 80242.00 英镑。VC 组中没有收到患者或工作人员的正式投诉。
虚拟 2-ww LGI 诊所是有效，安全的，并具有切实的环境和经济效益。
