Virtual orthopaedic clinic follow-up for upper limb arthroplasty in a tertiary referral centre.

Aim: Follow-up for upper limb arthroplasty often requires costly and long-distance travel for patients. This pilot study outlines the process of implementing a virtual clinic (VC) review pathway, and assesses patient satisfaction, safety and costs. Methods: Trust ethics approval was sought prior to implementation. The VC review pathway involved a locally performed X-ray, requested by the general practitioner, followed by a proforma-based telephone questionnaire with a clinical nurse specialist. Following the VC appointment, a telephone satisfaction survey was performed, which included overall satisfaction, a friends and family test, and time for feedback. Conversion back to traditional clinic review and adverse events were recorded. Results: Eighty-four patients were reviewed out of 101 invited. Of those, 89% reported the VC was the same or better than standard follow-up and 93% would recommend the VC to friends or family. There were no adverse events or missed diagnoses recorded. Discussion: This pilot study supports the introduction of a VC review pathway, which provides high satisfaction, reduced cost and no adverse events. Clarifying challenges highlighted by GPs and patients will improve uptake of the pathway. Our institution is now preparing to expand the pathway model to other disciplines.