Cystic Fibrosis patients trial virtual appointments to improve access to care
Great-grandfather Greg King is becoming tech savvy.
"I'd rate the virtual appointments to monitor my CF far ahead of visits to the hospital. It's so much easier to sit in front of my computer at home," he said.
At 74, Greg is the oldest of the 250 patients at Royal Prince Alfred Hospital's multidisciplinary adult Cystic Fibrosis (CF) Clinic – the biggest in New South Wales.
CF is the most common life limiting genetic disorder in Australia, with respiratory failure the most likely cause of death.
It is recommended patients with the disease attend a specialist CF Clinic for a review every three months, depending on the severity of their condition.
During the check-up, patients see various specialists including a respiratory physician, physiotherapist, endocrinologist and dietician and undergo a lung function test.
"About 80 per cent of our patients live outside of Sydney Local Health District. About 40 per cent live in rural New South Wales," Dr Sheila Sivam, a respiratory physician at RPA's Cystic Fibrosis Clinic, said.
"Travel, accommodation, work and childcare needs may make it hard for them to access regular multi-disciplinary CF care," she said.
A push to improve patient access to tertiary level CF care, prompted a decision to trial offering patients a combination of virtual and face-to-face appointments in January 2020.
The introduction of COVID-19 restrictions in March led to a big drop in Clinic attendance, but it improved as patients opted for virtual appointments via video conferencing.
During the 12-month trial, patients have the opportunity for virtual consultations with specialists and are also provided with a portable spirometer to measure their lung function.
Last year, the CF team won $25 000 in the District's quarterly staff innovation competition, The Pitch, and used the money to buy the spirometers.
"The newest spirometer uses an app to automatically upload test results. The results are also added to their Electronic Medical Record. We hope to obtain a spirometry reading every three months to monitor the patient's lung health," Jody Bell, a respiratory scientist, said.
Greg is one of 67 patients who have so far opted to take-up virtual appointments.
He's upgraded his home computer, speakers and web cam and installed video conferencing software ahead of his first virtual appointment.
"I had a conversation with Dr Sivam. It was great to see people on the screen. I have another virtual appointment in October," Greg said.
The CF Clinic is being supported by rpavirtual who contact each patient ahead of their appointment and ensure the video conferencing platform is working properly, so the consultation will run smoothly.
Patients also have the opportunity to participate in a study about the use of virtual appointments. They'll be asked to complete surveys to measure their quality of life, fatigue, emotional and mental well-being, sleep quality and patient satisfaction.
At the end of the study, each patient's experience will be evaluated, as will the financial costs and time commitment for virtual appointments when compared to the face-to-face care provided at the Clinic.
"Virtual appointments may be a practical way to improve access and attendance at the Clinic and most importantly, monitor and improve our patient's health," Dr Sivam said.