Introduction ‘Virtual clinics’ are a relatively recent concept that can be used to assess, and deliver advice about, specific patients without the requirement to review them face-to-face in an outpatient clinic. The consultant running the clinic reviews the referral, blood results and imaging to make an assessment before corresponding with the referrer. This audit was completed to assess the impact of the introduction of a regional hepatology virtual clinic.
Methods All referrals to hepatology outpatients between 1 Dec 2014 and 30 Nov 2015 were triaged by 4 consultants and those that were deemed suitable for virtual clinic assessment were passed on to a single consultant. All referrals dealt with by the virtual clinic were analysed retrospectively. Virtual clinic letters stored on an online system were used to collect data on the source of and reason for referral, the diagnosis and any advice given.
Results 148 referrals were dealt with by the virtual clinic out of a total of 1420 referrals to the hepatology service. Of those, 87% were sent by General Practitioners (GPs), with the remainder being referred from various hospital specialities. The most common indications for virtual clinic management included misinterpretation of iron profile/HFE genotyping results (28%), Gilbert’s Syndrome (14%), isolated GGT elevation (10%), benign liver lesions on imaging (10%), non-alcoholic fatty liver disease (NAFLD) (8%), misinterpretation of Hepatitis B/C serology (6%) and transient elevations in LFTs associated with acute illness (4%). Only 4 (3%) referrals dealt with by the virtual clinic ultimately required formal review in a hepatology clinic and these were due to deteriorating LFTs post-referral.
Conclusion A virtual hepatology clinic can safely deal with 10% of referrals and reduce the number of face to face clinic appointments required. This will in turn reduce clinic waiting lists, to the benefit of those patients in need of a clinic appointment. Lastly this audit identifies topics that could be incorporated into education sessions for GPs to help modify referral practise.
Disclosure of Interest None Declared
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