Introduction Outpatient visits to secondary care are costly to Primary Care (PC), time consuming for patients and not always appropriate. Our Trust having been a pioneer in nephrology e-Consultation (eC), we started a hepatology eC service in March 2012. This allows patients’ records to be shared between PC and secondary care (SC) without the need for a detailed referral letter.
Our aims were to analyse our initial experience and perform a cost analysis of hepatology eC.
Methods Retrospective analysis of eC between Mar 12- Oct 13 using SystmOne. Tariffs used for cost analysis: new patient (NP) referral £181, follow up (FU) £103, eC £24.
Results In 18 months there were 81 eC (31M/50F mean age 52/56 y), each taking 10–15 min to complete. The median response time was 2 days (43% within 1 day). Referral reasons: isolated raised bilirubin/ALT/ALP/GGT: 44/81 (54%), mixed raised LFT’s: 16/81 (20%), abnormal radiology 10%, hyperferritinaemia 9%, HBV/HCV 4%, general advice 2%. There was one inappropriate referral. In 18 cases, SC referral was recommended (22%), with 10/18 being referred and seen. The mean number of FU appointments was 3. Total cost to PC was £8,114: eC £1,944 and £6,170 for subsequent referrals. A minimum cost saving of £14,890 was made (81 NP (£14,661) and assuming one FU for each (£8,343)).
Conclusion eC is a rapid, cost-effective method of providing hepatology advice. Hidden costs including consultant time, clinic costs etc are difficult to quantify. We would, however, recommend eC as the way forward with a more appropriate tariff.
Disclosure of Interest None Declared.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.