Teleconsultation to evaluate the anaesthetic needs of patients

Date:  23 April 2024

Overview

Entre Douro e Vouga Local Health Unit introduced video calls to evaluate the anaesthetic needs of patients. These teleconsultations avoid unnecessary trips to the hospital. They have reduced a) costs to the patient and the health provider, b) the rate of missed appointments, c) time spent away from work, and d) the number of people within hospital grounds. Importantly, this initiative also improves sustainability by reducing the hospital’s environmental impact. It is estimated that more than 13,000 consultations in the hospital department could be done by video call every year. This could lead to a reduction of approximately 70 tons of CO2 emissions every year.

Background

Before surgery, all patients’ anaesthetic needs are assessed. At Entre Douro e Vouga Hospital, more than 13,000 anaesthesiology consultations are carried out every year, which means that around 26,000 journeys between home and hospital take place. The environmental footprint of these journeys is significant, which is why the Local Health Unit worked to find a solution that could mitigate environmental impact, while maintaining the clinical safety of the pre-surgery anaesthetic assessment.

Solution proposed

The Local Health Unit decided to reduce the number of visits using a teleconsultation system for eligible patients. They chose to use the SNS24 mobile app that was developed by the Central Administration of Health Systems (ACSS). It connects to the appointment booking system so that the patient can connect through the app without the need for a face-to-face consultation. On a video call, the patient’s medical information is shared and an assessment of the patient’s general condition, and particularly their airway, is conducted.

Patients are contacted by the Unit’s team with information about the teleconsultation method and how to access it. On the day of the consultation, the anaesthesiologist calls the patient, lets them know that they are going to start the consultation, and then carries out the consultation. Teleconsultation speeds up consultation times and increase the productivity of the team. They also avoid the patient taking time off work to attend a face-to-face appointment. The security of patient data is guaranteed by the government application.

Challenges

The main barrier for this project has been the lack of knowledge about using mobile apps among some patients, particularly older patients. However, the Unit reports that this challenge has improved over time by providing a detailed explanation about how to access the app.

Expected impact and vision of the project

In terms of impacts, there is a reduction of absenteeism from work, and a reduction of greenhouse gas emissions that would have been generated by travelling to the hospital. In a hospital where more than 13,000 anaesthetic consultations are carried out every year, it is estimated that the full roll-out of teleconsultations could lead to a reduction of more than 70 tonnes of CO2 emissions per year.

Measurable impacts

To date, 240 video consultations have been carried out, leading to savings of approximately 622 litres of fuel and 1290 kg of CO2 emissions. A total of 10,545 kilometres and 179 hours spent travelling to the hospital were avoided. (These figures exclude patients living in London and Luanda, which would have increased the impact of travel to the hospital.)

It is estimated that more than 13,000 consultations in the hospital department could be done by video call every year. This could result in savings of approximately 66,500 euros in fuel and a reduction of approximately 70 tons of CO2 emissions every year.

Introducing video calls to evaluate the anaesthetic needs of patients in all of Portugal, and even all over the world, can clearly contribute to  more sustainable healthcare.

Health equity

This project also had a positive impact on inclusion and improving the accessibility of healthcare for the most vulnerable populations. The team can ensure that people in remote areas and patients who find it difficult to travel (for physical, logistic, or financial reasons) have easier access to a proper assessment by an anaesthesiologist, speeding up the process to carry out their surgeries and improve their comfort.

 Co-benefits

One of the co-benefits of teleconsultation is a reduced risk of infections associated with contact between patients and between patients and healthcare professionals. Another important co-benefit is improved wellbeing for patients – they do not have to travel to the hospital, which is often a very long journey including time spent looking for a parking space and waiting for the appointment. In addition, the patient does not have to miss work, which indirectly reduces absenteeism and increases workforce productivity generally.

With more than 13.000 consultations a year, the team is confident that this project will definitely reduce the environmental impact of the hospital and contribute to its transition to low-carbon healthcare through clinical practice.

Written by:

Renzo Costa