Ireland East Hospital Group: Virtual Consultation

Background

The Ireland East Hospital Group (IEHG) is Ireland’s largest hospital network with a unique profile of local services and focused tertiary specialties. The group comprises eleven hospitals, providing a wide range of acute, elective, inpatient, and outpatient services to over 1 million people.

As part of its strategy to deliver high-quality patient care in the most cost-effective manner, and reduce physical face-to-face appointments, IEHG adopted video and telephone to deliver some outpatient consultations. The aim was to:

• Minimise physical attendances, protecting patients, staff and the community, particularly during the Coronavirus (COVID-19) pandemic.
• Reduce the cost of attending hospital appointments for patients and their carers/families, including the cost of travel, car parking, childcare, and time off work.
• Improve patient satisfaction and convenience.
• Increase remote working for clinicians.
• Reduce carbon emissions from traveling to appointments.

Solution

IEHG hospitals, including Mater Misericordiae University Hospital (MMUH), Royal Victoria Eye and Ear Hospital (RVEEH), and St.Vincent's University Hospital (SVUH) selected T-Pro as their preferred supplier of virtual consultation to help provide necessary care to patients, who can attend their appointment from almost anywhere, without needing to visit a hospital/clinic. The system also facilitates remote working for clinicians. This allowed clinicians who needed to self-isolate or to shield as a result of COVID-19, to safely continue with their patients’ appointments, avoiding the need to cancel these appointments.

T-Pro eClinic Manager is a fully integrated, web-based platform that allows healthcare organisations to put on virtual clinics and enable clinicians to treat patients online using video or telephone consultation through their smartphones, tablets, and desktop computers.

• Automatically schedule a video appointment from any PAS scheduled visit or create one manually.
• Send patients a secure link via email or SMS to access their appointment.
• Route waiting room patients to the right clinic, track patient wait time, triage, and prep patients from the comfort of their homes.
• Customise templates for new appointments, reminders, cancellations, etc.
• Support for multidisciplinary teams working with group video sessions.
• Instant chat messaging as an additional communication option.
• Virtual waiting room allows you to see when the next patient has checked in.
• Immediate access to contextually appropriate patient records.
• Generate attendance reports for compliance and reimbursement.
• Support GDPR requirements for patient security and confidentiality by employing secure encryption methods.
• Connected to T-Pro’s Digital Dictation & Speech Recognition, allowing clinicians to document the patient encounter directly within the virtual clinic platform, and view contextually appropriate patient correspondence.

"T-Pro worked closely with all key stakeholders across the Hospital, including Clinical, Operations, Admin and IMS to produce a fully integrated virtual consultation solution in our Outpatient Department. The T-Pro platform has allowed us to automate the patient notification processes for virtual consultation appointments. We are able to handle video, telephone and face to face appointments in one consolidated system.

T-Pro continues to support us to further improve the systems for both Mater Hospital staff and patients. We look forward to continuing with T-Pro as part of our project team, and together delivering a successful long-lasting digital transformation."

Jenny Costello
EHR Applications Lead, Mater Misericordiae University Hospital

Benefits

The use of virtual consultations at the hospitals increased rapidly when the nationwide lockdown to reduce the spread of the coronavirus was implemented. At the beginning of March 2020, IEHG hospitals conducted around 200 virtual consultations per week. This increased substantially following the announcement of the lockdown measures. This figure continues to rise. By the end of April 2020, there were over 50 different services across the group, conducting virtual consultations with patients using T-Pro.

T-Pro conducted an evaluation of attendance statistics, patient and clinician views relating to their virtual consultations. Of the 113 patients and staff that responded:

• 92% did not require a face-to-face follow-up or were discharged. This is above the comparison for first contact benchmarks reported by health services, which typically sit at 60%.
• 81% would have traveled to their face-to-face appointment by car; this saved 135kg of CO2 emissions, the equivalent of a single person flying from London to Barcelona.
• 66% of staff reported an improved experience whilst conducting virtual clinics, and were able to deal with increased capacity, seeing more patients than traditional face-to-face only clinics.

Other Outcomes

• Scaling to high patient volume achieved
• Attendance rates increased
• Improving patient choice and experience 
• Optimizing staff time 
• Cost savings
• Supporting recruitment & retention

Next steps & Sustainability

As IEHG hospitals move to the recovery phase post-COVID-19, a digital by default process will be adopted across hospital sites. Virtual consultations will be the ‘new normal’ where appropriate. To sustain current levels of use, some IEHG hospitals have implemented an outpatient pathway system using T-Pro that is an end-to-end process. GPs can refer patients who will be discussed and streamed by the clinician. The patient will be offered a virtual consultation and will receive a secure text and/or email invitation sent by T-Pro. Clinicians have the option of conducting the virtual consultation using video or telephone.

Following the virtual consultation, clinicians can easily document the patient encounter naturally and efficiently - using T-Pro’s integrated Digital Dictation & Speech Recognition workflow platform. A copy of the subsequent letter is then intelligently routed back to the electronic patient record system and electronically distributed to patients, GPs, or other external recipients - delivering cost savings and improving letter turnaround.