Can we attend anywhere? Evaluation of multidisciplinary team (MDT) remote consultations

Morrison, L.; McTavish, D.; Carlisle, V.

Objectives: To assess the value of remote consultation (RC) for people with cystic fibrosis (pwCF). A pilot of physiotherapy/dietitian-specific clinics found RC to be an acceptable alternative to standard clinics. Due to COVID19, RC was introduced to replace MDT face-to-face (F2F) clinics. Methods: RC's were run 2x weekly. 117 pwCF were surveyed to evaluate previous experience of RC, usefulness of this consultation and preference in continuing. We asked 9 MDT members about their perception and opinion of RC. Results: 55% pwCF and 100% MDT responded.100% found RC useful and 90% stating time efficiency despite 62% having no previous experience. 80% of pwCF preferred video over telephone calls. 72% of respondents had concerns re: lack of lung function measurement, 56% were concerned re: lack of physical examination which was also raised by the MDT. Confidentiality was identified as a concern but 72% of pwCF felt they had no problem discussing sensitive issues but these would be preferable F2F. Benefits included reduced clinic time (80%), convenience of not travelling/parking at hospital (90%) and ease of clinic allocation irrespective of microbiology infection control concerns (70%). Flexibility of access, not requiring time off work, a relaxed discussion of more relevant issues and improvements in clinical flow were noted. F2F consultations remain valuable as these build relationships and allow thorough examination. Conclusion: 64% pwCF and all MDT agreed that alternating RC would be a preferable format, with frequency depending on clinical need. This would minimise travel and cross infection risks whilst continuing optimal clinical care. RC were well received and a viable option to increase review when clinical space is limited. Concern over lack of objective measurement is important as these are clinically required and should be obtained. Technical issues e.g. poor connection, lack of equipment and training should be considered when planning this type of consultation.