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. 2023 Jul;105(6):561-567.
doi: 10.1308/rcsann.2022.0144. Epub 2023 Jan 23.

Outcomes of remote versus face-to-face ear, nose and throat outpatient consultation on patient pathways

T Gupta  1 , M F Bhutta  1   2
Affiliations

Outcomes of remote versus face-to-face ear, nose and throat outpatient consultation on patient pathways

T Gupta et al. Ann R Coll Surg Engl. 2023 Jul.

Abstract

Introduction: Remote consultation has potential benefits in increasing patient pathway efficiency and has been found to reduce costs and carbon emissions. Previous studies of remote consultation in ear, nose and throat (ENT) practice have reported mixed results and used relatively small sample sizes. The aim of this article is to study the impact of remote telephone consultation on ENT clinic outcomes and pathway efficiency, compared with in-person review, within new and follow-up patient cohorts and subspeciality, where previous studies demonstrate mixed and inconclusive results.

Methods: This was a comparison of remote clinic appointment outcomes over a 2-month period from a single ENT referral centre (426) with an equivalent data set of face-to-face clinic appointments over a similar time frame (1,533). Statistical analysis included chi-squared test for clinic outcomes and two-sample t-squared test for mean hand-off between both cohorts (p < 0.05).

Results: For new referrals, remote consultation was associated with statistically significantly greater rates of follow-up (p < 0.00001), investigation (p = 0.00251) and hand-off (p < 0.00013) than patients seen face-to-face - particularly where presenting with head and neck symptoms. For follow-up patients, remote consultation had similar rates of investigation (p = 0.11071) or further follow-up (p = 0.08) and mean hand-off (p < 0.11764) to those seen face-to-face.

Conclusions: Remote consultation in ENT could become the norm for follow-up patients, but should be used with caution in the initial consultation of new patients.

Keywords: ENT; Efficiency; Follow-up; Hand-off; Remote consultation.

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Figures

Figure 1
Figure 1
Outcomes of consultation for (a) new patients seen remotely, (b) new patients seen face-to-face (F2F), (c) follow-up patients seen remotely and (d) follow-up patients seen F2F. GP = general practitioner; VRC = virtual remote clinic
Figure 1
Figure 1
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