PTH-46 Telemedicine outpatient hepatology clinics: A patient survey and notes audit during the COVID-19 pandemic

IntroductionThe Covid pandemic in March 2020 necessitated the introduction of virtual clinic phone reviews (VC) as an alternative to face-to-face reviews (F2F). We aimed to study patient satisfaction and clinical effectiveness of VC in the setting of general hepatology outpatients.MethodsWe conducted a phone survey of patients (n=60) who underwent a VC during a week in November 2021 from five general hepatology clinics from different consultants at a tertiary referral centre in London. Decompensated liver disease patients from specialist alcohol and cirrhosis clinics were excluded. Patient satisfaction was scored from 1 – 10 (10 = extremely satisfied). We also performed a retrospective notes audit to review clinician rated effectiveness of the clinics looking at criteria such as appropriate triage, whether investigations/bloods were required to complete the review or if a physical exam was needed.ResultsThe survey was completed by 39 of 60 patients contacted (median age 54 yrs, range 23-85 yrs;M:F 19: 19 male, 4 had cirrhosis). 32 clinic visits were follow up and 7 were new. 90% of patients had access to internet and 100% had a phone. Viral hepatitis was the most common aetiology (42%), then NAFLD (13%) and AIH (10%). The median satisfaction score was 8 (4.5-10). Compared to F2F, 72% reported they had enough time, 85% felt the doctor listened, 85% got answers to questions, 90% had confidence in their doctor and 95% understood the management plan. 63% would prefer the option of VC post pandemic. There was no significant difference in ages between patients that preferred VC and those that didn’t (mean 51y vs 55y;p=0.22). Travel distance and first language also did not appear to be associated with preference for VC. There was a significant difference (p=0.03) in unemployment between patients that preferred F2F (71%) compared to VC (29%). Most patients that preferred future VC still stated their ideal ratio would be 50:50. VC were rated as ineffective if requested bloods tests were not done within 4 weeks (42%, n=14) or a physical exam would have been required (n=2).ConclusionOur results indicate that the majority of patients with well compensated liver disease found virtual reviews acceptable but would still prefer an equal ratio of VC and F2F appointments in the future. Patient preference was not predicted by age, travel distance or first language, in contrast to employment status. Further studies are required to improve the clinical effectiveness of virtual reviews and patient satisfaction, including optimising triage criteria and improving access to investigations.2910 characters (max 3000 inc. spaces – includes title, authors and affiliations)