Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Dig Dis. 2023;41(4):600-603. doi: 10.1159/000530165. Epub 2023 Mar 24.
Colonoscopy is a commonly performed procedure, but most patients will not actually be found with colorectal cancer. Subsequent face-to-face consultations to explain post-colonoscopy findings are common despite the time and cost-saving benefits of teleconsultation, especially in a post-COVID-19 era. This exploratory retrospective study examined the proportion of post-colonoscopy follow-up consultations that could have been converted to teleconsultation within a tertiary hospital in Singapore.
A retrospective cohort of all patients who underwent colonoscopy in the institution from July to September 2019 was identified. All follow-up face-to-face consultations related to the index colonoscopy from the scope date to 6 months post-colonoscopy were traced. Clinical data relevant to the index colonoscopy and these consultations were extracted from electronic medical records.
The cohort consisted of 859 patients (68.5% male, age range: 18-96 years). Of these, 15 (1.7%) had colorectal cancer, but the majority (n = 643, 74.9%) were scheduled for at least one post-colonoscopy visit - a total of 884 face-to-face clinical visits. The final sample was 682 (77.1%) face-to-face post-colonoscopy visits that did not involve any procedures performed or indicated the need for any subsequent follow-up.
If such "unnecessary" post-colonoscopy consultations exist within our institution, then similar situations possibly occur elsewhere. As COVID-19 continues to periodically tax healthcare systems worldwide, preservation of resources will remain integral alongside quality standards of routine patient care. There is a need for detailed analyses and modeling to hypothesize potential savings by also considering the start-up and maintenance costs of switching to a teleconsultation-dominated system.
结肠镜检查是一种常见的检查程序，但大多数患者实际上不会发现结直肠癌。尽管远程咨询具有节省时间和成本的优势，尤其是在后 COVID-19 时代，但随后进行面对面解释结肠镜检查结果的咨询仍然很常见。本探索性回顾性研究检查了新加坡一家三级医院中，结肠镜检查后随访咨询中有多少可以转换为远程咨询。
从 2019 年 7 月至 9 月，对该机构进行结肠镜检查的所有患者进行了回顾性队列研究。从镜检日期到结肠镜检查后 6 个月，追踪了与索引结肠镜检查相关的所有后续面对面咨询。从电子病历中提取与索引结肠镜检查和这些咨询相关的临床数据。
该队列包括 859 名患者（68.5%为男性，年龄范围：18-96 岁）。其中 15 名（1.7%）患有结直肠癌，但大多数（n=643，74.9%）患者计划至少进行一次结肠镜检查后随访——共 884 次面对面临床访问。最终样本为 682 次（77.1%）无任何操作或表明需要进一步随访的结肠镜检查后不必要的面对面随访。
如果我们医院存在这种“不必要”的结肠镜检查后咨询，那么其他地方也可能存在类似情况。随着 COVID-19 继续周期性地给全球医疗系统带来压力，在保持资源的同时，也需要将常规患者护理的质量标准作为医疗系统的核心。需要进行详细的分析和建模，通过考虑切换到以远程咨询为主的系统的启动和维护成本，来假设潜在的节省。
