Prospective clinical, cost analysis and environmental impact of a clinician-led virtual ureteric colic treatment decision pathway
BAUS ePoster online library. Edison M. Jun 25, 2019; 259488; P12-4 Disclosure(s): MJC is funded by the Wellcome Trust
Dr. Marie Edison
Dr. Marie Edison
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Abstract
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Introduction: Virtual clinic (VC) is a clinical consultation without a face-to-face (FTF) meeting. Incorporating innovative telehealth strategies such as a VC in the follow-up pathway for patients is one such method to clinically and fiscally accommodate the increasing service demands of uncomplicated ureteric colic.

Patients & Methods: All referrals to a single tertiary endourology unit covering two accident and emergency units were prospectively collected between August 2015 and January 2018. Ureteric colic patients requiring emergency admission were excluded. Patients of working age (18-65 years), time (days) from referral to VC, VC outcome including surgical intervention were collected. A cost and environmental impact analysis was also performed.

RESULTS:
687 patients were identified. 91% (622) were of working age. Median time from presentation to VC was 2 days (IQR 1-5). Our VC Outcomes were: 14.0% (96) discharged, 14.6% (100) discharged following further VC, 52.4% (360) FTF clinic, 19.1% (131) intervention. Our interventions arm included: PCNL 0.7% (5), ESWL 7.9% (54), URS 10.5% (72). Our VC saved an estimated £40, 348 for clinical commissioning groups. 6,009 patient journey miles were avoided which would have equated to 0.45 -1.88 metric tonnes of CO2e production and the need to plant 9.4 trees to achieve carbon balance.

Conclusion: Clinician-led VC reduces time to treatment decision to a median of 2 days. This creates additional clinic capacity, reducing the fiscal burden and carbon footprint of traditional stone clinics.
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