A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic

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 CO_2e, depending on mode of transport. Our predicted 12-month avoided carbon footprint is 1.04-4.04 metric tonnes of CO_2e.

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.

Keywords: Carbon footprint; Environment; Telemedicine; Urology virtual clinic.

Figure 1

Clinical outcomes of virtual clinic (VC); Clinic = rebook face-to-face clinic; MDT = discuss at multidisciplinary team meeting.

Figure 2

Patient satisfaction level of our service using a five-point Likert scale (1: very unhappy, 2: unhappy, 3: Neither happy or unhappy, 4: happy, 5: very happy).