76 Outcomes of virtual appointments at GOSH

Background The need to upscale virtual consultations has been made apparent during the COVID pandemic. This study explores the effectiveness of virtual visits. Method A questionnaire was sent to clinicians about their experience and the effectiveness of face-to-face, video and telephone appointments based on ease of assessment and decision-making. Ethical approval was not required. Survey results were compared to outpatient clinic visit outcomes of June 2019 and June 2020. Results Survey - Of 95 completed questionnaires, over 75% reported they were often able to complete a medical and social history and make a diagnosis during virtual visits. Identifying non-verbal cues, ascertaining clinical signs, and starting treatment was more challenging, especially via telephone. CLINIC VISIT OUTCOMES: June’19 Further contact required - 35% (32% F2F; 3% Tel) Discharge – 6% (5% F2F; 1% Tel) Decision to Admit – 5% (5% F2F; 1% Tel) June’20 Further contact required – 46% (14% F2F; 21% Tel; 11% Vid) Discharge – 7% (1% F2F; 4% Tel; 2% Vid) Decision to admit – 4% (1% F2F; 2% Tel; 1% Vid) DNA/WNB OUTCOMES Further Contact Required June’19 – 71% (70% F2F; 1% Tel) June’20 - 81% (20% F2F; 43% Tel; 18% Video) Discussion Virtual appointments can be an effective alternative when examination is not required. There was no relationship between decision to admit and appointment type, and the highest percentage of patients were discharged following telephone visits, highlighting that virtual visits may be more appropriate for some patients. Video visits bridge the gap between face-to-face and telephone appointments, easing the identification of non-verbal cues and clinical signs. Lack of additional cues however may explain why clinicians reschedule more telephone visits following WNB attendances than other visit types. Conclusion Results suggest that clinicians are able to deliver care virtually in a meaningful manner, allowing for clinical assessment and appropriate decision-making.