Virtual clinics: Need of the hour, a way forward in the future. Adapting practice during a healthcare crisis.

Dear Sir,

The whole world is gripped by the novel coronavirus pandemic, with huge pressures on the health services globally. Within the coming days, this is only going to increase the pressure on the health care services and needs robust planning and preparedness for this unprecedented situation, lest the whole system may cripple and we may see unimaginable mortalities and suffering.

The whole concept of social distancing and keeping people in self isolation has reduced footfall to the hospitals but this is affecting delivery of routine care to patients for other illnesses in the hospital and telehealth is an upcoming way to reduce the risk of cross contamination as well as reduce close contact without affecting the quality of health care delivered.

At the Bedford hospital NHS trust, for the past one year we have been running a virtual clinic for our skin cancer suspect patients, where in after a particular biopsy if the clinical suspicion of a malignancy was low, these patients were not given a follow up clinic appointment and instead they were informed of the biopsy result through post, sent both to their GP and themselves. Most patients encouraged this model to not have to come back to an appointment and this took significant pressure off our clinics. In the event we needed to see a patient, they were informed via a telephonic conversation to attend a particular clinic appointment. From an administration standpoint, this resulted in less unnecessary follow up appointments in our skin cancer follow up clinics, which could then be offered to our regular skin cancer follow up patients as per the recommended guidelines, without having to struggle with appointments.

Virtual clinics have previously shown to be safe and cost effective alternatives to the Out patient visits in surgical departments like Urology and Orthopedics. They improved performance as well as improved economic output. ,

We have increased the use of these virtual clinics, with the onset of the novel Coronavirus pandemic, in order to reduce the patient footfall to our clinics. Most patients voluntarily chose not to turn up and with the risk being highest amongst the elderly, it was logical to keep them away from hospitals as far as possible. In order to achieve this, we have started virtual clinics for nearly all patients in order to triage patients that can do without having to come to the hospital for now.

The world of telemedicine is the way forward in nearly all aspects of medical practice and this pandemic situation might just be the right time to establish such methods. We propose setting up of more such clinics in as many subspecialties of plastic surgery, which not only will help in the current crises situation, but will also be useful in the future to take pressure of our health care services.

Declaration of Competing Interest

None declared