Evaluating a “virtual” urology out-patient clinic to address delays in review patients

Introduction: Ireland has the one of the lowest urologist per population ratios in Europe1 Out-patient department (OPD) visits are time consuming, costly and frequently patients cannot be reviewed in the intended timeframe2 With the COVID-19 crisis innovative virtual models of care are essential Methods: Patients for OPD review were assessed by a Consultant in a “virtual” clinic using electronic records (letters, imaging, blood results) and chart review if required Patients were either discharged, discharged for GP testing with specified re-referral criteria, phone/letter follow up by a LUTS clinical nurse specialist, investigated and reviewed by phone/letter, or returned for face-to-face consultation Results: 400 patients were assessed The majority were seen previously by SHO or junior registrar 160 (40%) patients were discharged directly via letter and advice 121 (30%) required further imaging and could be contacted by phone with the results 79 (20%) could be contacted by the LUTS clinical nurse specialist for phone/written review 40 (10%) necessitated face-to-face OPD review for clinical assessment or investigation review In 47 patients there was insufficient information available in the electronic platforms, thus requiring formal chart review Overall, 360 patients could be managed via “virtual” means The potential out-patient cost savings were estimated at €27,000 Conclusion: With this COVID-19 pandemic, innovative models of care are necessitated Introduction of a “virtual” OPD clinic allows reliable review of patients with reduced face-to-face follow-up attendances Further study of staff training and patient satisfaction is required