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Miah S, Dunford C, Edison M, Eldred-Evans D, Gan C, Shah TT, Lunn P, Winkler M, Ahmed HU, Gibbons N, Hrouda D. A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic. Ann R Coll Surg Engl 2019; 101:30-34. [PMID: 30286648 PMCID: PMC6303818 DOI: 10.1308/rcsann.2018.0151] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2018] [Indexed: 12/18/2022] Open
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 CO2e, depending on mode of transport. Our predicted 12-month avoided carbon footprint is 1.04-4.04 metric tonnes of CO2e. 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.
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Affiliation(s)
- S Miah
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
- Both are first joint authors
| | - C Dunford
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Both are first joint authors
| | - M Edison
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - D Eldred-Evans
- Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - C Gan
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - TT Shah
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - P Lunn
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - M Winkler
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - HU Ahmed
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - N Gibbons
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - D Hrouda
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
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