P067 Virtual care: the future, but to what extent?
Authors: Rutter-locher Zoe , Arumalla Nikita , Bright Zoe , Garrood Toby 
Published: April 2021

Background/Aims 

The COVID-19 pandemic has necessitated profound changes to the delivery of healthcare in the UK. Our aim was to analyse whether a move to virtual care is beneficial and sustainable in a rheumatology outpatient setting.

Methods 

Data on volume of unscheduled access to an outpatient rheumatology service and questionnaire feedback responses from patients and rheumatology clinicians on virtual consultations, was analysed.

Results 

During the COVID-19 pandemic period of March - July 2020, our department saw a majority of face to face outpatient rheumatology clinic appointments transferred to virtual (telephone/video) with a significant reduction in the number of scheduled clinics. In addition, the volume of telephone appointments booked online by patients saw a 27.2% rise (n = 2248) compared to March - July 2019 (n = 1767), with a 23.7% increase in telephone helpline calls in the 2020 period (n = 3246) compared to 2019 (n = 2624) and over a 300% increase in email helpline activity. Questionnaire responses were obtained from 382 patients (Table 1). 86% of patients felt they got a lot out of a virtual appointment, but 13% would prefer not to use it again. Of the 16 healthcare providers that responded, 12 (75%) were satisfied with the virtual clinic set up, but only 2/16 (13%) felt the same could be achieved for patients in a virtual setting compared to a face-to-face visit. The lack of clinical examination was a major limitation for clinicians 12/16 (75%) and was similarly identified amongst patient feedback (42/260) (16%).

Conclusion 

Virtual care with the provision for patient-led care allows convenience for the patient with high patient satisfaction, however this is not necessarily an approach that suits all. Clinicians must beware the non-complaining patient, and careful selection of those suitable for virtual care may be needed. Our model of patient led care using telephone appointments booked online by patients coupled with telephone/email helplines is a potential strategy for other centers to develop. Ongoing patient and healthcare provider feedback, data on the effect on clinical outcomes and detailed quality improvement cycles are vital to adjust services over the coming months. P067 Table 1:Results of patient survey on Virtual Clinic experienceDemographicsGenderFemale293 (77%)AgeAge 16-64269 (70%)Age 65-80+94 (25%)RaceWhite British233 (60%)BAME72 (18%)ConsultationsModeTelephone366 (96%)Video11 (3%)TypeNew45 (13%)Follow up333 (87%)ClinicianDoctor324 (85%)Nurse32 (8%)AHP26 (7%)Time from appointment to contactOn time or early195(51%)Up to 15 minutes57 (15%)15-30 minutes36 (9%)&gt;30 minutes41 (11%)Length of appointment&lt;15 minutes184 (48%)15-30 minutes164 (43%)&gt;30 minutes23 (6%)FeedbackWas the length of the appointment right?About right352 (92%)Too short19 (5%)Did you get everything out of this appointment as you would in a face-to-face session?Yes, definitely206 (54%)Yes, to some extent121 (32%)No49 (13%)Did you feel involved in the decision made about your care?Yes, definitely277 (73%)Yes, to some extent57 (15%)No21 (6%)Did you feel you received the information you required?Yes, definitely251 (66%)Yes, to some extent92 (24%)No16 (4%)How would you rate the appointment?Very good/good327 (86%)Neither good nor poor24 (6%)Poor/very poor14 (4%)Would you prefer to use this again for your next appointment?Yes, definitely124 (32%)Yes, to some extent182 (48%)No61 (16%)*Missing data if patient did not respond to the questions.

Disclosure 

Z. Rutter-locher: None. N. Arumalla: None. Z. Bright: None. T. Garrood: None.