Virtual outpatient consultants are the new norm

Dr Yvonne Smyth, a consultant cardiologist at University Hospital Galway.

Dr Yvonne Smyth, a consultant cardiologist at University Hospital Galway.

More than 36,000 virtual outpatient clinics have been conducted by clinical teams at Galway University Hospitals (University Hospital Galway and Merlin Park University Hospital ) since the start of the Covid-19 pandemic.

The move away from face-to-face outpatient consultations has been necessary due to concerns over the health and safety risks it would pose to employees and patients.

Chris Kane, the manager of Galway University Hospitals, said the pandemic has had a huge impact on how patient services are delivered at both University Hospital Galway and Merlin Park University Hospital.

"Almost overnight clinical teams had to re-assess how they could safely manage patients and put plans and processes in place to enable that. It was not possible, from the perspective of both patient and staff safety, to run many of our face-to-face outpatient clinics so our clinical teams used technology to link with patients and continue to monitor them.

"This was very challenging as our hospitals normally deliver over 280,000 outpatient appointments every year. However, all our clinical teams reacted really quickly to the rapidly evolving situation and put systems in place to ensure that their patients continued to have access to care. Our electronic patient record system Evolve was critical to enable our teams deliver virtual outpatient clinics as it meant that copies of scanned patient charts were readily available for staff to access."

Dr Yvonne Smyth, a consultant cardiologist at University Hospital Galway, outlined that the cardiology outpatient service at University Hospital Galway is "extremely busy".

"We see 9,500 patients each year. Prior to the onset on Covid-19 this involved up to seven clinics per week, with up to 50 patients attending each clinic. As the rate of Covid-19 in Ireland rapidly increased, it quickly became clear it would not be possible to run our cardiology outpatient clinics as we traditionally had."

In addition to the unacceptable risk of having large numbers of patients waiting in close proximity, the hospital was also conscious of the profile of its cardiology patients, many of whom were older and had other underlying health conditions that made it necessary for them to cocoon, while some patients required support of family members to also attend, further increasing the numbers of people at the clinic.

"All of these issues made it particularly important for us to quickly find an alternative way of delivering our outpatient cardiology service. We began initially with telephone consultations and later included video consults; to date we have delivered 3,800 virtual cardiology outpatient appointments. All our patients adapted quickly to the technology and found the opportunity to link with us, despite Covid-19, very reassuring.

"Of course, if we felt at any time that a patient needed to be seen in person, we made arrangements to do that and all the necessary infection prevention and control measures were taken. Our outpatient cardiac diagnostic service has resumed and patients attend in person for cardiac investigations including ECHO and stress testing."

She added it was important to note that emergency cardiology services continued around the clock throughout this period and she urged patients not to delay seeking medical help if they experience chest pain or other symptoms of a heart attack.


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