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Telephone and video appointments for follow-up patients

by Elizabeth MacPhie | May 24, 2020 | in Rheumatology

All of our appointments for established rheumatology patients have moved to telephone appointments. With the volume of patients involved we have not been able to offer every patient the option of video or telephone, but when needed we do have the option of a video consultant using Attend Anywhere.  Patients have been happy to have their appointment by telephone and many have asked whether this is something we could continue to offer in the future especially if they are doing well, as far more efficient.

What is needed to sustain the change?

Telephone appointments have worked really well and we are keen to now consider how we incorporate virtual appointments into our pathways. We realise that some patients will require a face-to-face, for example those with an IA where we need an objective assessment of their joints, especially if changes are being made to their treatment (eg starting biologic), or patients with CTD who need BP and urine checks. However, these could be interspersed with virtual appts if patients are doing well.

So we are now starting to consider how we "screen" patients prior to their appt. We are exploring in the first instance whether a member of the team could contact the patient to get a baseline as to how they are, if well then option would be a telephone/video and details about AttendAnywhere can be pushed to the patient by email.  Ideally we are keen to incorporate PROMS into this assessment and currently exploring how this can be done. 

Long term we would hope that we could make better use of technology eg set up text alerts to help patients inform us at to their preference of appt, push PROMs to patients ahead of their appt to also inform the process

We need to review our clinic templates so that we can incorporate different types of appts and potentially free up clinic space if we can have dedicated remote clinics and face-to-face clinics.

What is your region?

North West

edited on Jul 13, 2020 by Kyle Beacham
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Carol McCrum May 24, 2020

Hi Elizabeth
It is really valuable to read your post. Our service is doing a similar approach , both Attend Anywhere and telephone, depending on patient preference, and also offered opportunity for preferred days/times.

I wondered if you are aware of any previous Rheum teleheath strategies locally or globally that have been able to successfully use video and be reliable with joint swelling observations with the challenge of screen distortion,.
Thank you for sharing your strategies

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Elizabeth MacPhie May 24, 2020

Not aware of anyone formally assessing joint swelling by video though aware of one project which is in development using video & recording patients hand movements to assess synovitis...… Sounds far too technical for me. I have to say I struggle to assess swelling by video and have had to bring patients back for a F2F review if they need a formal assessment

However, there has been work done on a patient reported DAS28 and NRAS have developed an App for patients to undertake a self-reported DAS28
https://www.nras.org.uk/know-your-das-mobile-app
Haven't used it BUT our team are keen to explore and looking into this.....

For patients with AxSpa there is another App
https://www.talkpsa.co.uk/myspa-mobile-app
Our physios are using this already, patients then download a PDF of their scores and email it through to the physios

Lizzy

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Greta McLachlan Jun 12, 2020

Status labels added: Investment In Technology, Patient Activation, Patient Selection, Telephone Advice, Telephone Consulting, Horizon 1

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Greta McLachlan Jun 15, 2020

The idea has been progressed to the next milestone.

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Kyle Beacham Jul 13, 2020

Status labels removed: Investment In Technology, Patient Activation, Patient Selection, Telephone Advice, Telephone Consulting

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