A specialised IBD advice line and nurse-led virtual clinic improves patient access to care as well as reducing healthcare costs, Australian research shows.
A Sydney study comprised 550 patients who accessed the services at the Liverpool Hospital during the study period in 2015-16.
The advice line includes a phone and email service managed by IBD specialist nurses.
The virtual clinic is a planned, formal communication between the GE and the IBD specialist nurse who first reviews and triages all incoming patient results and investigation reports. A management plan is then communicated by the nurse to the patient, and GP as necessary, and documented accordingly.
Of 220 advice line enquiries, 180 were for medical queries and 40 were administrative in nature.
“Between June 2015 and June 2016, 53 GP visits, 159 IBD outpatient department visits, six ED presentations, and one hospital admission were avoided as a result of the nurse-led advice line consultations.”
Outpatient visits were sometimes avoided if the nurses could address their concerns, if further investigations were required, or if patients were redirected to their GP or an alternate specialist depending on the nature of their enquiries.
The virtual clinic also reduced the number of outpatient department visits by 954, ED presentations by 58 and four GP visits. On one occasion, a patient was instructed to present to ED as the result of a virtual clinic consult
Some ED visits were avoided as patients were expedited through to an OPD appointment.
As with the advice line, many of the OPD visits were avoided if further investigations were required or if patients were redirected to their GP or an alternate specialist.
The study, published in the European Journal of Gastroenterology and Hepatology, found the avoidance of GP, OPD and ED presentations equates to a gross saving of $169,376 during the 12-month study period.
The incurred costs resulting from the advice line and virtual clinic interventions equates to $58,713 during the same period.
“The implementation of the two nurse-led interventions examined in this article is, thus, estimated to lead to an annual net saving of AUD $110,663.80, calculated using the MBS and IHPA.”
“Furthermore, the considerable reductions in the number of ED representations as well as IBD OPD visits as the result of the implementation of the virtual clinic is arguably an indication of improved quality of life and disease control.”
The investigators, led by Dr Neda Karimi from the Ingham Institute for Applied Medical Research, said nursing skills and expertise were generally underutilised.
“The interventions introduced in this article were designed in a way to ensure that the IBD nurse consultant’s skills and knowledge are utilised to the full potential, the utilisation of the IBD consultant is reduced when it is not medically necessary, and at the same time, all patients who need specialist care receive it in a timely manner.”
“Nurse-led interventions are an integral component of IBD care the need for which is highlighted in situations such as the current COVID-19 pandemic,” they concluded.